Implant-specific follow-up imaging of treated intracranial aneurysms: TOF-MRA vs. metal artifact reduced intravenous flat panel computed tomography angiography (FPCTA).

Abstract:

AIM:To compare the diagnostic quality of time-of-flight magnetic resonance angiography (TOF-MRA) and metal-artefact-reduction (MAR) flat-panel-detector computed tomography angiography (FPCTA) and to determine the imaging technique best suited for evaluation endovascular and surgically treated aneurysms. METHODS:The image quality of TOF-MRA and MAR-FPCTA of 44 intracranial implants (coiling: n=20; clipping: n=15; coiling + stenting: n=9) in a patient cohort of 25 was evaluated by two independent readers. Images obtained using MAR-FPCTA (20 second scan time, 496 projections, intravenous contrast medium administration; Artis Zee, Siemens Healthcare, Forchheim) were compared with TOF-MRA-images (1.5 or 3 T). Nominal data were analysed using McNemar's chi-square test and ordinal variables using the Wilcoxon rank test. RESULTS:Compared to TOF-MRA, MAR-FPCTA was significantly better suited to detect aneurysm remnants and to evaluate parent vessels after clipping (p<0.01). For coil packages >160 mm3, TOF-MRA provided significantly better assessment than MAR-FPCTA (p<0.01). For small coil packages (<160 mm3), no significant difference between TOF-MRA and MAR-FPCTA (p=0.232) was observed. For different clip sizes (cut-off 492 mm3) likewise no significant differences were found. The interobserver comparison showed high interrater agreement. CONCLUSION:MAR-FPCTA is significantly better suited for follow-up examinations of clipped aneurysms, whereas for larger coil packages TOF-MRA is preferable. Smaller coil packages can be analysed using MAR-FPCTA or TOF-MRA.

journal_name

Clin Radiol

journal_title

Clinical radiology

authors

Hänsel NH,Schubert GA,Scholz B,Nikoubashman O,Othman AE,Wiesmann M,Pjontek R,Brockmann MA

doi

10.1016/j.crad.2017.07.011

subject

Has Abstract

pub_date

2018-02-01 00:00:00

pages

218.e9-218.e15

issue

2

eissn

0009-9260

issn

1365-229X

pii

S0009-9260(17)30386-0

journal_volume

73

pub_type

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