Document Detail


Three-dimensional time-of-flight MR angiography at 3 T compared to digital subtraction angiography in the follow-up of ruptured and coiled intracranial aneurysms: a prospective study.
MedLine Citation:
PMID:  18196229     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
INTRODUCTION: Since digital subtraction angiography (DSA) carries a low risk of morbidity, and is associated with patient discomfort and higher cost, our objective was to determine whether high-resolution 3-D time-of-flight MR angiography (TOF-MRA) at 3 T may replace DSA in the follow-up of patients after coiling of an intracranial aneurysm. METHODS: This prospective study included 50 consecutive patients with a ruptured and subsequently coiled intracranial aneurysm. All patients were followed up at a mean of 14 months after coiling with DSA and high-resolution 3-D TOF-MRA at 3 T generating 0.02 mm3 isotropic voxels. One examiner used DSA and TOF-MR angiograms to assess the need for and risk of retreatment; these data were used to calculate intermodality agreement. Another two examiners independently assessed aneurysm occlusion by DSA and TOF-MRA according to the Raymond scale; these data were used to calculate interobserver agreement. RESULTS: Discrepancies between DSA and TOF-MRA were found in three patients (intermodality agreement kappa=0.86). While DSA indicated complete aneurysm occlusion, TOF-MRA showed small neck remnants in the three patients. Coils on all DSA projections obscured these three neck remnants. Interobserver agreement was higher for DSA (kappa=0.82) than for TOF-MRA (kappa=0.68), which was in part due to the complexity of the information provided by TOF source images and reconstructions. CONCLUSION: 3-D TOF-MRA at 3 T is not only an adjunctive tool but is ready to replace DSA in the follow-up of patients with previously coiled intracranial aneurysms. Additional DSA may only be performed in complex and not clearly laid out aneurysms.
Authors:
H Urbach; U Dorenbeck; M von Falkenhausen; K Wilhelm; W Willinek; C Schaller; S Flacke
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Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article    
Journal Detail:
Title:  Neuroradiology     Volume:  50     ISSN:  0028-3940     ISO Abbreviation:  Neuroradiology     Publication Date:  2008 May 
Date Detail:
Created Date:  2008-09-05     Completed Date:  2008-11-18     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  1302751     Medline TA:  Neuroradiology     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  383-9     Citation Subset:  IM    
Affiliation:
Department of Radiology, University of Bonn Medical Centre, Bonn, Germany. urbach@uni-bonn.de
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aged
Aneurysm, Ruptured / radiography*,  therapy
Angiography, Digital Subtraction*
Child
Embolization, Therapeutic
Female
Follow-Up Studies
Humans
Imaging, Three-Dimensional*
Intracranial Aneurysm / radiography*,  therapy
Magnetic Resonance Angiography*
Male
Middle Aged
Observer Variation
Prospective Studies
Treatment Outcome

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


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