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<meta name="DC.Title" content="A Prospective Trial of 3T and 1.5T Time-of-Flight and Contrast-Enhanced MR Angiography in the Follow-Up of Coiled Intracranial Aneurysms" />
<meta name="DC.Identifier" content="10.3174/ajnr.A1932" />
<meta name="DC.Date" content="2010-05-01" />
<meta name="DC.Publisher" content="American Journal of Neuroradiology" />
<meta name="DC.Rights" content="Copyright © American Society of Neuroradiology" />
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<meta name="DC.Description" content="BACKGROUND AND PURPOSE: Endovascularly coiled intracranial aneurysms are increasingly being followed up with noninvasive MRA imaging to evaluate for aneurysm recurrences. It has not been well-established which MRA techniques are best for this application, however. Our aim was to prospectively compare 4 MRA techniques, TOF and CE-MRA at 1.5T and 3T, to a reference standard of DSA in the evaluation of previously endovascularly coiled intracranial aneurysms.

MATERIALS AND METHODS: Fifty-eight subjects with 63 previously coiled intracranial aneurysms underwent all 4 MRA techniques within 8 days of DSA. There were 2 outcome variables: coil occlusion class (class 1, complete; class 2, dog ear; class 3, residual neck; class 4, aneurysm filling) and change in degree of occlusion since the previous comparison. Sensitivity and specificity were computed for each MRA technique relative to the reference standard of DSA. Differences among the MRA techniques were evaluated in pair-wise fashion by using the McNemar test.

RESULTS: For the detection of any aneurysm remnant, the sensitivity was 85%–90% for all MRA techniques. Sensitivity dropped to 50%–67% when calculated for the detection of only the class 3 and 4 aneurysm remnants, because several class 3 and 4 remnants were misclassified as class 2 by MRA. CE-MRA at 1.5T and 3T misclassified fewer of the class 3 and 4 remnants than did TOF-MRA at 1.5T, as reflected by the significantly greater sensitivity for larger aneurysm remnants with CE-MRA relative to TOF-MRA at 1.5T ( P = .0455 for both comparisons).

CONCLUSIONS: CE-MRA is more likely than TOF-MRA to classify larger aneurysm remnants appropriately. We recommend performing both CE-MRA and TOF-MRA in the follow-up of coiled intracranial aneurysms and at 3T if available.

ASNR
:   American Society of Neuroradiology
CAQ
:   Certificate of Added Qualification
CE
:   contrast-enhanced
DSA
:   digital subtraction angiography
LOC
:   locations
MIP
:   maximum intensity projection
MRA
:   MR angiography
SNR
:   signal intensity–to noise ratio
SPGR
:   spoiled gradient-recalled echo
TOF
:   time-of-flight" />
<meta name="DC.Contributor" content="T.J. Kaufmann" />
<meta name="DC.Contributor" content="J. Huston" />
<meta name="DC.Contributor" content="H.J. Cloft" />
<meta name="DC.Contributor" content="J. Mandrekar" />
<meta name="DC.Contributor" content="L. Gray" />
<meta name="DC.Contributor" content="M.A. Bernstein" />
<meta name="DC.Contributor" content="J.L. Atkinson" />
<meta name="DC.Contributor" content="D.F. Kallmes" />
<meta name="article:published_time" content="2010-05-01" />
<meta name="article:section" content="Interventional" />
<meta name="citation_title" content="A Prospective Trial of 3T and 1.5T Time-of-Flight and Contrast-Enhanced MR Angiography in the Follow-Up of Coiled Intracranial Aneurysms" />
<meta name="citation_abstract" lang="en" content="&lt;h3&gt;BACKGROUND AND PURPOSE:&lt;/h3&gt;
&lt;p&gt;Endovascularly coiled intracranial aneurysms are increasingly being followed up with noninvasive MRA imaging to evaluate for aneurysm recurrences. It has not been well-established which MRA techniques are best for this application, however. Our aim was to prospectively compare 4 MRA techniques, TOF and CE-MRA at 1.5T and 3T, to a reference standard of DSA in the evaluation of previously endovascularly coiled intracranial aneurysms.&lt;/p&gt;&lt;h3&gt;MATERIALS AND METHODS:&lt;/h3&gt;
&lt;p&gt;Fifty-eight subjects with 63 previously coiled intracranial aneurysms underwent all 4 MRA techniques within 8 days of DSA. There were 2 outcome variables: coil occlusion class (class 1, complete; class 2, dog ear; class 3, residual neck; class 4, aneurysm filling) and change in degree of occlusion since the previous comparison. Sensitivity and specificity were computed for each MRA technique relative to the reference standard of DSA. Differences among the MRA techniques were evaluated in pair-wise fashion by using the McNemar test.&lt;/p&gt;&lt;h3&gt;RESULTS:&lt;/h3&gt;
&lt;p&gt;For the detection of any aneurysm remnant, the sensitivity was 85%–90% for all MRA techniques. Sensitivity dropped to 50%–67% when calculated for the detection of only the class 3 and 4 aneurysm remnants, because several class 3 and 4 remnants were misclassified as class 2 by MRA. CE-MRA at 1.5T and 3T misclassified fewer of the class 3 and 4 remnants than did TOF-MRA at 1.5T, as reflected by the significantly greater sensitivity for larger aneurysm remnants with CE-MRA relative to TOF-MRA at 1.5T (&lt;i&gt;P&lt;/i&gt; = .0455 for both comparisons).&lt;/p&gt;&lt;h3&gt;CONCLUSIONS:&lt;/h3&gt;
&lt;p&gt;CE-MRA is more likely than TOF-MRA to classify larger aneurysm remnants appropriately. We recommend performing both CE-MRA and TOF-MRA in the follow-up of coiled intracranial aneurysms and at 3T if available.&lt;/p&gt;" />
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<meta name="twitter:title" content="A Prospective Trial of 3T and 1.5T Time-of-Flight and Contrast-Enhanced MR Angiography in the Follow-Up of Coiled Intracranial Aneurysms" />
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<meta name="twitter:description" content="BACKGROUND AND PURPOSE: Endovascularly coiled intracranial aneurysms are increasingly being followed up with noninvasive MRA imaging to evaluate for aneurysm recurrences. It has not been well-established which MRA techniques are best for this application, however. Our aim was to prospectively compare 4 MRA techniques, TOF and CE-MRA at 1.5T and 3T, to a reference standard of DSA in the evaluation of previously endovascularly coiled intracranial aneurysms.

MATERIALS AND METHODS: Fifty-eight subjects with 63 previously coiled intracranial aneurysms underwent all 4 MRA techniques within 8 days of DSA. There were 2 outcome variables: coil occlusion class (class 1, complete; class 2, dog ear; class 3, residual neck; class 4, aneurysm filling) and change in degree of occlusion since the previous comparison. Sensitivity and specificity were computed for each MRA technique relative to the reference standard of DSA. Differences among the MRA techniques were evaluated in pair-wise fashion by using the McNemar test.

RESULTS: For the detection of any aneurysm remnant, the sensitivity was 85%–90% for all MRA techniques. Sensitivity dropped to 50%–67% when calculated for the detection of only the class 3 and 4 aneurysm remnants, because several class 3 and 4 remnants were misclassified as class 2 by MRA. CE-MRA at 1.5T and 3T misclassified fewer of the class 3 and 4 remnants than did TOF-MRA at 1.5T, as reflected by the significantly greater sensitivity for larger aneurysm remnants with CE-MRA relative to TOF-MRA at 1.5T ( P = .0455 for both comparisons).

CONCLUSIONS: CE-MRA is more likely than TOF-MRA to classify larger aneurysm remnants appropriately. We recommend performing both CE-MRA and TOF-MRA in the follow-up of coiled intracranial aneurysms and at 3T if available.

ASNR
:   American Society of Neuroradiology
CAQ
:   Certificate of Added Qualification
CE
:   contrast-enhanced
DSA
:   digital subtraction angiography
LOC
:   locations
MIP
:   maximum intensity projection
MRA
:   MR angiography
SNR
:   signal intensity–to noise ratio
SPGR
:   spoiled gradient-recalled echo
TOF
:   time-of-flight" />
<meta name="og-title" property="og:title" content="A Prospective Trial of 3T and 1.5T Time-of-Flight and Contrast-Enhanced MR Angiography in the Follow-Up of Coiled Intracranial Aneurysms" />
<meta name="og-url" property="og:url" content="http://ajnr-stage2.stage.highwire.org/content/31/5/912" />
<meta name="og-site-name" property="og:site_name" content="American Journal of Neuroradiology" />
<meta name="og-description" property="og:description" content="BACKGROUND AND PURPOSE: Endovascularly coiled intracranial aneurysms are increasingly being followed up with noninvasive MRA imaging to evaluate for aneurysm recurrences. It has not been well-established which MRA techniques are best for this application, however. Our aim was to prospectively compare 4 MRA techniques, TOF and CE-MRA at 1.5T and 3T, to a reference standard of DSA in the evaluation of previously endovascularly coiled intracranial aneurysms.

MATERIALS AND METHODS: Fifty-eight subjects with 63 previously coiled intracranial aneurysms underwent all 4 MRA techniques within 8 days of DSA. There were 2 outcome variables: coil occlusion class (class 1, complete; class 2, dog ear; class 3, residual neck; class 4, aneurysm filling) and change in degree of occlusion since the previous comparison. Sensitivity and specificity were computed for each MRA technique relative to the reference standard of DSA. Differences among the MRA techniques were evaluated in pair-wise fashion by using the McNemar test.

RESULTS: For the detection of any aneurysm remnant, the sensitivity was 85%–90% for all MRA techniques. Sensitivity dropped to 50%–67% when calculated for the detection of only the class 3 and 4 aneurysm remnants, because several class 3 and 4 remnants were misclassified as class 2 by MRA. CE-MRA at 1.5T and 3T misclassified fewer of the class 3 and 4 remnants than did TOF-MRA at 1.5T, as reflected by the significantly greater sensitivity for larger aneurysm remnants with CE-MRA relative to TOF-MRA at 1.5T ( P = .0455 for both comparisons).

CONCLUSIONS: CE-MRA is more likely than TOF-MRA to classify larger aneurysm remnants appropriately. We recommend performing both CE-MRA and TOF-MRA in the follow-up of coiled intracranial aneurysms and at 3T if available.

ASNR
:   American Society of Neuroradiology
CAQ
:   Certificate of Added Qualification
CE
:   contrast-enhanced
DSA
:   digital subtraction angiography
LOC
:   locations
MIP
:   maximum intensity projection
MRA
:   MR angiography
SNR
:   signal intensity–to noise ratio
SPGR
:   spoiled gradient-recalled echo
TOF
:   time-of-flight" />
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      <h1 class="highwire-cite-title" id="page-title">A Prospective Trial of 3T and 1.5T Time-of-Flight and Contrast-Enhanced MR Angiography in the Follow-Up of Coiled Intracranial Aneurysms</h1>  
    	<div class="highwire-cite-authors"><span  class="highwire-citation-authors"><span class="highwire-citation-author first" data-delta="0">T.J. Kaufmann</span>, <span class="highwire-citation-author" data-delta="1">J. Huston</span>, <span class="highwire-citation-author" data-delta="2">H.J. Cloft</span>, <span class="highwire-citation-author" data-delta="3">J. Mandrekar</span>, <span class="highwire-citation-author" data-delta="4">L. Gray</span>, <span class="highwire-citation-author" data-delta="5">M.A. Bernstein</span>, <span class="highwire-citation-author" data-delta="6">J.L. Atkinson</span> and <span class="highwire-citation-author" data-delta="7">D.F. Kallmes</span></span></div>
  
    	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-journal highwire-cite-metadata">American Journal of Neuroradiology </span><span  class="highwire-cite-metadata-date highwire-cite-metadata">May 2010,  </span><span  class="highwire-cite-metadata-volume highwire-cite-metadata">31 </span><span  class="highwire-cite-metadata-issue highwire-cite-metadata">(5) </span><span  class="highwire-cite-metadata-pages highwire-cite-metadata">912-918; </span><span  class="highwire-cite-metadata-doi highwire-cite-metadata">DOI: https://doi.org/10.3174/ajnr.A1932 </span></div>
  
  
  
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<div id="hw-article-author-popups-top-node-9874--6316133420" style="display: none;"><div class="author-tooltip-0"><div class="author-tooltip-name">T.J. Kaufmann </div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=T.J.%2BKaufmann%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Kaufmann%20T&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link last"><a href="/search/author1%3AT.J.%2BKaufmann%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li></ul></div><div class="author-tooltip-1"><div class="author-tooltip-name">J. 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<p id="p-3"><strong>BACKGROUND AND PURPOSE:</strong> Endovascularly coiled intracranial aneurysms are increasingly being followed up with noninvasive MRA imaging to evaluate for aneurysm recurrences. It has not been well-established which MRA techniques are best for this application, however. Our aim was to prospectively compare 4 MRA techniques, TOF and CE-MRA at 1.5T and 3T, to a reference standard of DSA in the evaluation of previously endovascularly coiled intracranial aneurysms.</p>
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<p id="p-4"><strong>MATERIALS AND METHODS:</strong> Fifty-eight subjects with 63 previously coiled intracranial aneurysms underwent all 4 MRA techniques within 8 days of DSA. There were 2 outcome variables: coil occlusion class (class 1, complete; class 2, dog ear; class 3, residual neck; class 4, aneurysm filling) and change in degree of occlusion since the previous comparison. Sensitivity and specificity were computed for each MRA technique relative to the reference standard of DSA. Differences among the MRA techniques were evaluated in pair-wise fashion by using the McNemar test.</p>
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<p id="p-5"><strong>RESULTS:</strong> For the detection of any aneurysm remnant, the sensitivity was 85%–90% for all MRA techniques. Sensitivity dropped to 50%–67% when calculated for the detection of only the class 3 and 4 aneurysm remnants, because several class 3 and 4 remnants were misclassified as class 2 by MRA. CE-MRA at 1.5T and 3T misclassified fewer of the class 3 and 4 remnants than did TOF-MRA at 1.5T, as reflected by the significantly greater sensitivity for larger aneurysm remnants with CE-MRA relative to TOF-MRA at 1.5T (<em>P</em> = .0455 for both comparisons).</p>
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<p id="p-6"><strong>CONCLUSIONS:</strong> CE-MRA is more likely than TOF-MRA to classify larger aneurysm remnants appropriately. We recommend performing both CE-MRA and TOF-MRA in the follow-up of coiled intracranial aneurysms and at 3T if available.</p>
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</div><div class="section glossary" id="glossary-1"><h2>Abbreviations</h2><dl id="def-list-1"><dt id="def-item-1">ASNR<span class="def-item-dt-sep"></span></dt><dd>American Society of Neuroradiology<span class="def-item-dd-sep"></span></dd><dt id="def-item-2">CAQ<span class="def-item-dt-sep"></span></dt><dd>Certificate of Added Qualification<span class="def-item-dd-sep"></span></dd><dt id="def-item-3">CE<span class="def-item-dt-sep"></span></dt><dd>contrast-enhanced<span class="def-item-dd-sep"></span></dd><dt id="def-item-4">DSA<span class="def-item-dt-sep"></span></dt><dd>digital subtraction angiography<span class="def-item-dd-sep"></span></dd><dt id="def-item-5">LOC<span class="def-item-dt-sep"></span></dt><dd>locations<span class="def-item-dd-sep"></span></dd><dt id="def-item-6">MIP<span class="def-item-dt-sep"></span></dt><dd>maximum intensity projection<span class="def-item-dd-sep"></span></dd><dt id="def-item-7">MRA<span class="def-item-dt-sep"></span></dt><dd>MR angiography<span class="def-item-dd-sep"></span></dd><dt id="def-item-8">SNR<span class="def-item-dt-sep"></span></dt><dd>signal intensity–to noise ratio<span class="def-item-dd-sep"></span></dd><dt id="def-item-9">SPGR<span class="def-item-dt-sep"></span></dt><dd>spoiled gradient-recalled echo<span class="def-item-dd-sep"></span></dd><dt id="def-item-10">TOF<span class="def-item-dt-sep"></span></dt><dd>time-of-flight</dd></dl></div><ul class="copyright-statement"><li class="fn" id="copyright-statement-1">Copyright © American Society of Neuroradiology</li></ul><span class="highwire-journal-article-marker-end"></span></div><span class="related-urls"></span></div><a href="http://ajnr-stage2.stage.highwire.org/content/31/5/912.full" class="hw-link hw-link-article-full-text" data-icon-position="" data-hide-link-title="0">View Full Text</a></div>  </div>

  
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      <div class="highwire-cite-title">A Prospective Trial of 3T and 1.5T Time-of-Flight and Contrast-Enhanced MR Angiography in the Follow-Up of Coiled Intracranial Aneurysms</div>  
    	<div class="highwire-cite-authors"><span  class="highwire-citation-authors"><span class="highwire-citation-author first" data-delta="0"><span class="nlm-given-names">T.J.</span> <span class="nlm-surname">Kaufmann</span></span>, <span class="highwire-citation-author" data-delta="1"><span class="nlm-given-names">J.</span> <span class="nlm-surname">Huston</span></span>, <span class="highwire-citation-author" data-delta="2"><span class="nlm-given-names">H.J.</span> <span class="nlm-surname">Cloft</span></span>, <span class="highwire-citation-author" data-delta="3"><span class="nlm-given-names">J.</span> <span class="nlm-surname">Mandrekar</span></span>, <span class="highwire-citation-author" data-delta="4"><span class="nlm-given-names">L.</span> <span class="nlm-surname">Gray</span></span>, <span class="highwire-citation-author" data-delta="5"><span class="nlm-given-names">M.A.</span> <span class="nlm-surname">Bernstein</span></span>, <span class="highwire-citation-author" data-delta="6"><span class="nlm-given-names">J.L.</span> <span class="nlm-surname">Atkinson</span></span>, <span class="highwire-citation-author" data-delta="7"><span class="nlm-given-names">D.F.</span> <span class="nlm-surname">Kallmes</span></span></span></div>
  
    	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-journal highwire-cite-metadata">American Journal of Neuroradiology </span><span  class="highwire-cite-metadata-date highwire-cite-metadata">May 2010, </span><span  class="highwire-cite-metadata-volume highwire-cite-metadata">31 </span><span  class="highwire-cite-metadata-issue highwire-cite-metadata">(5) </span><span  class="highwire-cite-metadata-pages highwire-cite-metadata">912-918; </span><span  class="highwire-cite-metadata-doi highwire-cite-metadata"><span class="label">DOI:</span> 10.3174/ajnr.A1932 </span></div>
  
  
  
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      <div class="highwire-cite-title">A Prospective Trial of 3T and 1.5T Time-of-Flight and Contrast-Enhanced MR Angiography in the Follow-Up of Coiled Intracranial Aneurysms</div>  
    	<div class="highwire-cite-authors"><span  class="highwire-citation-authors"><span class="highwire-citation-author first" data-delta="0"><span class="nlm-given-names">T.J.</span> <span class="nlm-surname">Kaufmann</span></span>, <span class="highwire-citation-author" data-delta="1"><span class="nlm-given-names">J.</span> <span class="nlm-surname">Huston</span></span>, <span class="highwire-citation-author" data-delta="2"><span class="nlm-given-names">H.J.</span> <span class="nlm-surname">Cloft</span></span>, <span class="highwire-citation-author" data-delta="3"><span class="nlm-given-names">J.</span> <span class="nlm-surname">Mandrekar</span></span>, <span class="highwire-citation-author" data-delta="4"><span class="nlm-given-names">L.</span> <span class="nlm-surname">Gray</span></span>, <span class="highwire-citation-author" data-delta="5"><span class="nlm-given-names">M.A.</span> <span class="nlm-surname">Bernstein</span></span>, <span class="highwire-citation-author" data-delta="6"><span class="nlm-given-names">J.L.</span> <span class="nlm-surname">Atkinson</span></span>, <span class="highwire-citation-author" data-delta="7"><span class="nlm-given-names">D.F.</span> <span class="nlm-surname">Kallmes</span></span></span></div>
  
    	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-journal highwire-cite-metadata">American Journal of Neuroradiology </span><span  class="highwire-cite-metadata-date highwire-cite-metadata">May 2010, </span><span  class="highwire-cite-metadata-volume highwire-cite-metadata">31 </span><span  class="highwire-cite-metadata-issue highwire-cite-metadata">(5) </span><span  class="highwire-cite-metadata-pages highwire-cite-metadata">912-918; </span><span  class="highwire-cite-metadata-doi highwire-cite-metadata"><span class="label">DOI:</span> 10.3174/ajnr.A1932 </span></div>
  
  
  
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