Document Detail


Characterization of aneurysm remnants after endovascular treatment: contrast-enhanced MR angiography versus catheter digital subtraction angiography.
MedLine Citation:
PMID:  18499789     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND AND PURPOSE: A substantial percentage of coiled aneurysms are associated with persistent filling of an aneurysmal component due to incomplete initial treatment or re-growth. Traditionally follow-up of coiled aneurysms has consisted of repeated intra-arterial cerebral catheter angiography, an invasive procedure with associated risks. Hence, many authors have advocated the use of non-invasive imaging techniques for this purpose. Our aim was to compare contrast-enhanced MR angiography (CE-MRA) with digital subtraction angiography (DSA) for depiction of aneurysmal remnants of coiled cerebral aneurysms. MATERIALS AND METHODS: Aneurysms coiled between September 2003 and October 2006 were retrospectively reviewed. We included patients meeting the following criteria: 1) residual/recurrent aneurysm measuring 2 mm or greater, and 2) CE-MRA and DSA performed no more than 60 days apart. Three readers were asked to determine which technique was superior for characterization of the aneurysmal remnant: CE-MRA, DSA, or indeterminate. Statistical analysis included most rule and kappa statistics. RESULTS: Of 232 patients who underwent coiling, 44 met the inclusion criteria (33 women and 11 men; 24-72 years of age). Sixteen patients had neck remnants and 28 had body remnants. The first study to identify the remnant was DSA in 35 patients and CE-MRA in 9. In 32 patients (32/44, 73%), the readers indicated that CE-MRA was superior to DSA for remnant characterization. CE-MRA and DSA were thought to be equivalent in 7 (16%), and DSA was preferred in 3 (7%). Two cases (5%) yielded ambiguous results. Of the 28 body remnants, 22 (78.6%) were characterized by remnant protrusion into the coil mass: In 20 of these (91%), the readers preferred CE-MRA over DSA, and in 2 cases (9%), the techniques were thought to be equivalent. CONCLUSION: In patients with known aneurysm remnants, CE-MRA is at least equivalent to DSA for characterization of aneurysmal remnants after coiling. Contrast filling within the coil mass was more clearly seen with CE-MRA than with DSA.
Authors:
R Agid; R A Willinsky; S-K Lee; K G Terbrugge; R I Farb
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Publication Detail:
Type:  Comparative Study; Controlled Clinical Trial; Journal Article     Date:  2008-05-22
Journal Detail:
Title:  AJNR. American journal of neuroradiology     Volume:  29     ISSN:  1936-959X     ISO Abbreviation:  AJNR Am J Neuroradiol     Publication Date:  2008 Sep 
Date Detail:
Created Date:  2008-09-10     Completed Date:  2008-11-24     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8003708     Medline TA:  AJNR Am J Neuroradiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1570-4     Citation Subset:  IM    
Affiliation:
Department of Medical Imaging, Division of Neuroradiology, Toronto Western Hospital, University of Toronto, Toronto, Ontario, Canada. ronit.agid@uhn.on.ca
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Angiography, Digital Subtraction / methods*
Contrast Media
Embolization, Therapeutic
Female
Humans
Intracranial Aneurysm / diagnosis*,  therapy*
Magnetic Resonance Imaging / methods*
Male
Middle Aged
Organometallic Compounds / diagnostic use*
Prognosis
Reproducibility of Results
Sensitivity and Specificity
Treatment Outcome
Chemical
Reg. No./Substance:
0/Contrast Media; 0/Organometallic Compounds; 138071-82-6/gadobutrol

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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