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<meta name="DC.Title" content="MR Imaging of Partially Thrombosed Cerebral Aneurysms: Characteristics and Evolution" />
<meta name="DC.Identifier" content="10.3174/ajnr.A2298" />
<meta name="DC.Date" content="2011-02-01" />
<meta name="DC.Publisher" content="American Journal of Neuroradiology" />
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<meta name="DC.Description" content="BACKGROUND AND PURPOSE: A comprehensive evaluation of aneurysmal morphometry requires appreciation of both the vascular lumen and the intraluminal thrombus. MR imaging methods can both evaluate the lumen and directly image the vessel wall. We investigated the ability of T1-weighted, T2-weighted, and steady-state MR imaging techniques to delineate thrombus morphology and reveal changes with time.

MATERIALS AND METHODS: Nine patients with fusiform basilar or intracranial vertebral artery aneurysms that contained intraluminal thrombus were studied with MR imaging. All patients underwent at least 2 imaging sessions, which were separated by 4–22 months. Analysis of signal intensity to determine the mean signal intensity from thrombus, blood, CSF, and brain in matched regions was performed. Aneurysm maximal diameter and cross-sectional area were determined with and without thrombus.

RESULTS: Thrombus was identified on all image sequences, and its general appearance was consistent between imaging sessions. Thrombus produced the highest and most consistent signal intensities with T1-weighted and steady-state techniques, though the latter showed superior contrast between luminal blood and thrombus. Heterogeneity within clot was evident in 4/9 of patients, with peripheral hyperintensity being a common feature.

CONCLUSIONS: Steady-state imaging was found to be superior to T1- and T2-weighted imaging for delineating and characterizing intraluminal thrombus within aneurysms. The imaging characteristics of intraluminal thrombus proved to be very consistent for long periods. Assessment of overall aneurysm size, including thrombosed portions, permits more accurate evaluation of aneurysm growth and concomitantly may permit more informed clinical decision-making with regard to the timing and need for aneurysm treatment.

BW
:   bandwidth
CE-MRA
:   contrast-enhanced MR angiography
MIP
:   maximum intensity projection
SENSE
:   sensitivity encoding
SSFP
:   steady-state free precession" />
<meta name="DC.Contributor" content="A.J. Martin" />
<meta name="DC.Contributor" content="S.W. Hetts" />
<meta name="DC.Contributor" content="W.P. Dillon" />
<meta name="DC.Contributor" content="R.T. Higashida" />
<meta name="DC.Contributor" content="V. Halbach" />
<meta name="DC.Contributor" content="C.F. Dowd" />
<meta name="DC.Contributor" content="M.T. Lawton" />
<meta name="DC.Contributor" content="D. Saloner" />
<meta name="article:published_time" content="2011-02-01" />
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<meta name="citation_title" content="MR Imaging of Partially Thrombosed Cerebral Aneurysms: Characteristics and Evolution" />
<meta name="citation_abstract" lang="en" content="&lt;h3&gt;BACKGROUND AND PURPOSE:&lt;/h3&gt;
&lt;p&gt;A comprehensive evaluation of aneurysmal morphometry requires appreciation of both the vascular lumen and the intraluminal thrombus. MR imaging methods can both evaluate the lumen and directly image the vessel wall. We investigated the ability of T1-weighted, T2-weighted, and steady-state MR imaging techniques to delineate thrombus morphology and reveal changes with time.&lt;/p&gt;&lt;h3&gt;MATERIALS AND METHODS:&lt;/h3&gt;
&lt;p&gt;Nine patients with fusiform basilar or intracranial vertebral artery aneurysms that contained intraluminal thrombus were studied with MR imaging. All patients underwent at least 2 imaging sessions, which were separated by 4–22 months. Analysis of signal intensity to determine the mean signal intensity from thrombus, blood, CSF, and brain in matched regions was performed. Aneurysm maximal diameter and cross-sectional area were determined with and without thrombus.&lt;/p&gt;&lt;h3&gt;RESULTS:&lt;/h3&gt;
&lt;p&gt;Thrombus was identified on all image sequences, and its general appearance was consistent between imaging sessions. Thrombus produced the highest and most consistent signal intensities with T1-weighted and steady-state techniques, though the latter showed superior contrast between luminal blood and thrombus. Heterogeneity within clot was evident in 4/9 of patients, with peripheral hyperintensity being a common feature.&lt;/p&gt;&lt;h3&gt;CONCLUSIONS:&lt;/h3&gt;
&lt;p&gt;Steady-state imaging was found to be superior to T1- and T2-weighted imaging for delineating and characterizing intraluminal thrombus within aneurysms. The imaging characteristics of intraluminal thrombus proved to be very consistent for long periods. Assessment of overall aneurysm size, including thrombosed portions, permits more accurate evaluation of aneurysm growth and concomitantly may permit more informed clinical decision-making with regard to the timing and need for aneurysm treatment.&lt;/p&gt;" />
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<meta name="twitter:title" content="MR Imaging of Partially Thrombosed Cerebral Aneurysms: Characteristics and Evolution" />
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<meta name="twitter:description" content="BACKGROUND AND PURPOSE: A comprehensive evaluation of aneurysmal morphometry requires appreciation of both the vascular lumen and the intraluminal thrombus. MR imaging methods can both evaluate the lumen and directly image the vessel wall. We investigated the ability of T1-weighted, T2-weighted, and steady-state MR imaging techniques to delineate thrombus morphology and reveal changes with time.

MATERIALS AND METHODS: Nine patients with fusiform basilar or intracranial vertebral artery aneurysms that contained intraluminal thrombus were studied with MR imaging. All patients underwent at least 2 imaging sessions, which were separated by 4–22 months. Analysis of signal intensity to determine the mean signal intensity from thrombus, blood, CSF, and brain in matched regions was performed. Aneurysm maximal diameter and cross-sectional area were determined with and without thrombus.

RESULTS: Thrombus was identified on all image sequences, and its general appearance was consistent between imaging sessions. Thrombus produced the highest and most consistent signal intensities with T1-weighted and steady-state techniques, though the latter showed superior contrast between luminal blood and thrombus. Heterogeneity within clot was evident in 4/9 of patients, with peripheral hyperintensity being a common feature.

CONCLUSIONS: Steady-state imaging was found to be superior to T1- and T2-weighted imaging for delineating and characterizing intraluminal thrombus within aneurysms. The imaging characteristics of intraluminal thrombus proved to be very consistent for long periods. Assessment of overall aneurysm size, including thrombosed portions, permits more accurate evaluation of aneurysm growth and concomitantly may permit more informed clinical decision-making with regard to the timing and need for aneurysm treatment.

BW
:   bandwidth
CE-MRA
:   contrast-enhanced MR angiography
MIP
:   maximum intensity projection
SENSE
:   sensitivity encoding
SSFP
:   steady-state free precession" />
<meta name="og-title" property="og:title" content="MR Imaging of Partially Thrombosed Cerebral Aneurysms: Characteristics and Evolution" />
<meta name="og-url" property="og:url" content="http://ajnr-stage2.stage.highwire.org/content/32/2/346" />
<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: A comprehensive evaluation of aneurysmal morphometry requires appreciation of both the vascular lumen and the intraluminal thrombus. MR imaging methods can both evaluate the lumen and directly image the vessel wall. We investigated the ability of T1-weighted, T2-weighted, and steady-state MR imaging techniques to delineate thrombus morphology and reveal changes with time.

MATERIALS AND METHODS: Nine patients with fusiform basilar or intracranial vertebral artery aneurysms that contained intraluminal thrombus were studied with MR imaging. All patients underwent at least 2 imaging sessions, which were separated by 4–22 months. Analysis of signal intensity to determine the mean signal intensity from thrombus, blood, CSF, and brain in matched regions was performed. Aneurysm maximal diameter and cross-sectional area were determined with and without thrombus.

RESULTS: Thrombus was identified on all image sequences, and its general appearance was consistent between imaging sessions. Thrombus produced the highest and most consistent signal intensities with T1-weighted and steady-state techniques, though the latter showed superior contrast between luminal blood and thrombus. Heterogeneity within clot was evident in 4/9 of patients, with peripheral hyperintensity being a common feature.

CONCLUSIONS: Steady-state imaging was found to be superior to T1- and T2-weighted imaging for delineating and characterizing intraluminal thrombus within aneurysms. The imaging characteristics of intraluminal thrombus proved to be very consistent for long periods. Assessment of overall aneurysm size, including thrombosed portions, permits more accurate evaluation of aneurysm growth and concomitantly may permit more informed clinical decision-making with regard to the timing and need for aneurysm treatment.

BW
:   bandwidth
CE-MRA
:   contrast-enhanced MR angiography
MIP
:   maximum intensity projection
SENSE
:   sensitivity encoding
SSFP
:   steady-state free precession" />
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<div id="hw-article-author-popups-top-node-9353--61079376254" style="display: none;"><div class="author-tooltip-0"><div class="author-tooltip-name">A.J. Martin </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=A.J.%2BMartin%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=Martin%20A&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%3AA.J.%2BMartin%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">S.W. 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    <div class="highwire-markup"><div xmlns="http://www.w3.org/1999/xhtml" xmlns:xhtml="http://www.w3.org/1999/xhtml" class="section ref-list" id="ref-list-1"><h2>References</h2><ol class="cit-list ref-use-labels"><li><span class="ref-label">1.</span><a class="rev-xref-ref" href="#xref-ref-1-1" title="View reference 1. in text" id="ref-1">↵</a>

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<div class="cit ref-cit ref-journal" id="cit-32.2.346.5" data-doi="10.1056/NEJM199812103392401"><div class="cit-metadata"><cite><span class="cit-article-title">Unruptured intracranial aneurysms: risk of rupture and risks of surgical intervention—International Study of Unruptured Intracranial Aneurysms Investigators</span>. <abbr class="cit-jnl-abbrev">N Engl J Med</abbr> <span class="cit-pub-date">1998</span>;<span class="cit-vol">339</span>:<span class="cit-fpage">1725</span>–<span class="cit-lpage">33</span></cite></div><div class="cit-extra"><a href="/lookup/external-ref?access_num=10.1056/NEJM199812103392401&amp;link_type=DOI" class="cit-ref-sprinkles cit-ref-sprinkles-doi cit-ref-sprinkles-crossref"><span>CrossRef</span></a><a href="/lookup/external-ref?access_num=9867550&amp;link_type=MED&amp;atom=%2Fajnr%2F32%2F2%2F346.atom" class="cit-ref-sprinkles cit-ref-sprinkles-medline"><span>PubMed</span></a><a href="/lookup/external-ref?access_num=000077459700001&amp;link_type=ISI" class="cit-ref-sprinkles cit-ref-sprinkles-newisilink cit-ref-sprinkles-webofscience"><span>Web of Science</span></a></div></div></li><li><span class="ref-label">6.</span><a class="rev-xref-ref" href="#xref-ref-6-1" title="View reference 6. in text" id="ref-6">↵</a>

<div class="cit ref-cit ref-journal" id="cit-32.2.346.6" data-doi="10.1016/S0140-6736(03)13860-3"><div class="cit-metadata"><ol class="cit-auth-list"><li><span class="cit-auth"><span class="cit-name-surname">Wiebers</span>  <span class="cit-name-given-names">DO</span></span>, </li><li><span class="cit-auth"><span class="cit-name-surname">Whisnant</span>  <span class="cit-name-given-names">JP</span></span>, </li><li><span class="cit-auth"><span class="cit-name-surname">Huston</span>  <span class="cit-name-given-names">J</span>  <span class="cit-name-suffix">3rd</span>.</span>, </li><li><span class="cit-etal">et al</span></li></ol><cite>. <span class="cit-article-title">Unruptured intracranial aneurysms: natural history, clinical outcome, and risks of surgical and endovascular treatment</span>. <abbr class="cit-jnl-abbrev">Lancet</abbr> <span class="cit-pub-date">2003</span>;<span class="cit-vol">362</span>:<span class="cit-fpage">103</span>–<span class="cit-lpage">10</span></cite></div><div class="cit-extra"><a href="/lookup/external-ref?access_num=10.1016/S0140-6736(03)13860-3&amp;link_type=DOI" class="cit-ref-sprinkles cit-ref-sprinkles-doi cit-ref-sprinkles-crossref"><span>CrossRef</span></a><a href="/lookup/external-ref?access_num=12867109&amp;link_type=MED&amp;atom=%2Fajnr%2F32%2F2%2F346.atom" class="cit-ref-sprinkles cit-ref-sprinkles-medline"><span>PubMed</span></a><a href="/lookup/external-ref?access_num=000184089200008&amp;link_type=ISI" class="cit-ref-sprinkles cit-ref-sprinkles-newisilink cit-ref-sprinkles-webofscience"><span>Web of Science</span></a></div></div></li><li><span class="ref-label">7.</span><a class="rev-xref-ref" href="#xref-ref-7-1" title="View reference 7. in text" id="ref-7">↵</a>

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<div class="cit ref-cit ref-journal" id="cit-32.2.346.8" data-doi="10.1007/s002340050679"><div class="cit-metadata"><ol class="cit-auth-list"><li><span class="cit-auth"><span class="cit-name-surname">Hademenos</span>  <span class="cit-name-given-names">GJ</span></span>, </li><li><span class="cit-auth"><span class="cit-name-surname">Massoud</span>  <span class="cit-name-given-names">TF</span></span>, </li><li><span class="cit-auth"><span class="cit-name-surname">Turjman</span>  <span class="cit-name-given-names">F</span></span>, </li><li><span class="cit-etal">et al</span></li></ol><cite>. <span class="cit-article-title">Anatomical and morphological factors correlating with rupture of intracranial aneurysms in patients referred for endovascular treatment</span>. <abbr class="cit-jnl-abbrev">Neuroradiology</abbr> <span class="cit-pub-date">1998</span>;<span class="cit-vol">40</span>:<span class="cit-fpage">755</span>–<span class="cit-lpage">60</span></cite></div><div class="cit-extra"><a href="/lookup/external-ref?access_num=10.1007/s002340050679&amp;link_type=DOI" class="cit-ref-sprinkles cit-ref-sprinkles-doi cit-ref-sprinkles-crossref"><span>CrossRef</span></a><a href="/lookup/external-ref?access_num=9860129&amp;link_type=MED&amp;atom=%2Fajnr%2F32%2F2%2F346.atom" class="cit-ref-sprinkles cit-ref-sprinkles-medline"><span>PubMed</span></a><a href="/lookup/external-ref?access_num=000077198300013&amp;link_type=ISI" class="cit-ref-sprinkles cit-ref-sprinkles-newisilink cit-ref-sprinkles-webofscience"><span>Web of Science</span></a></div></div></li><li><span class="ref-label">9.</span><a class="rev-xref-ref" href="#xref-ref-9-1" title="View reference 9. in text" id="ref-9">↵</a>

<div class="cit ref-cit ref-journal" id="cit-32.2.346.9"><div class="cit-metadata"><ol class="cit-auth-list"><li><span class="cit-auth"><span class="cit-name-surname">Cebral</span>  <span class="cit-name-given-names">JR</span></span>, </li><li><span class="cit-auth"><span class="cit-name-surname">Castro</span>  <span class="cit-name-given-names">MA</span></span>, </li><li><span class="cit-auth"><span class="cit-name-surname">Burgess</span>  <span class="cit-name-given-names">JE</span></span>, </li><li><span class="cit-etal">et al</span></li></ol><cite>. <span class="cit-article-title">Characterization of cerebral aneurysms for assessing risk of rupture by using patient-specific computational hemodynamics models</span>. <abbr class="cit-jnl-abbrev">AJNR Am J Neuroradiol</abbr> <span class="cit-pub-date">2005</span>;<span class="cit-vol">26</span>:<span class="cit-fpage">2550</span>–<span class="cit-lpage">59</span></cite></div><div class="cit-extra"><a href="/lookup/ijlink/YTozOntzOjQ6InBhdGgiO3M6MTQ6Ii9sb29rdXAvaWpsaW5rIjtzOjU6InF1ZXJ5IjthOjQ6e3M6ODoibGlua1R5cGUiO3M6NDoiQUJTVCI7czoxMToiam91cm5hbENvZGUiO3M6NDoiYWpuciI7czo1OiJyZXNpZCI7czoxMDoiMjYvMTAvMjU1MCI7czo0OiJhdG9tIjtzOjE5OiIvYWpuci8zMi8yLzM0Ni5hdG9tIjt9czo4OiJmcmFnbWVudCI7czowOiIiO30=" class="cit-ref-sprinkles cit-ref-sprinkles-ijlink"><span><span class="cit-reflinks-abstract">Abstract</span><span class="cit-sep cit-reflinks-variant-name-sep">/</span><span class="cit-reflinks-full-text"><span class="free-full-text">FREE </span>Full Text</span></span></a></div></div></li><li><span class="ref-label">10.</span><a class="rev-xref-ref" href="#xref-ref-10-1" title="View reference 10. in text" id="ref-10">↵</a>

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<div class="cit ref-cit ref-journal" id="cit-32.2.346.28" data-doi="10.3174/ajnr.A0796"><div class="cit-metadata"><ol class="cit-auth-list"><li><span class="cit-auth"><span class="cit-name-surname">Boussel</span>  <span class="cit-name-given-names">L</span></span>, </li><li><span class="cit-auth"><span class="cit-name-surname">Wintermark</span>  <span class="cit-name-given-names">M</span></span>, </li><li><span class="cit-auth"><span class="cit-name-surname">Martin</span>  <span class="cit-name-given-names">A</span></span>, </li><li><span class="cit-etal">et al</span></li></ol><cite>. <span class="cit-article-title">Monitoring serial change in the lumen and outer wall of vertebrobasilar aneurysms</span>. <abbr class="cit-jnl-abbrev">AJNR Am J Neuroradiol</abbr> <span class="cit-pub-date">2008</span>;<span class="cit-vol">29</span>:<span class="cit-fpage">259</span>–<span class="cit-lpage">64</span></cite></div><div class="cit-extra"><a href="/lookup/ijlink/YTozOntzOjQ6InBhdGgiO3M6MTQ6Ii9sb29rdXAvaWpsaW5rIjtzOjU6InF1ZXJ5IjthOjQ6e3M6ODoibGlua1R5cGUiO3M6NDoiQUJTVCI7czoxMToiam91cm5hbENvZGUiO3M6NDoiYWpuciI7czo1OiJyZXNpZCI7czo4OiIyOS8yLzI1OSI7czo0OiJhdG9tIjtzOjE5OiIvYWpuci8zMi8yLzM0Ni5hdG9tIjt9czo4OiJmcmFnbWVudCI7czowOiIiO30=" class="cit-ref-sprinkles cit-ref-sprinkles-ijlink"><span><span class="cit-reflinks-abstract">Abstract</span><span class="cit-sep cit-reflinks-variant-name-sep">/</span><span class="cit-reflinks-full-text"><span class="free-full-text">FREE </span>Full Text</span></span></a></div></div></li></ol></div></div>  </div>

  
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        	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-volume highwire-cite-metadata">Vol. 32</span>, <span  class="highwire-cite-metadata-issue highwire-cite-metadata">Issue 2 </span><div  class="highwire-cite-metadata-pubdate highwire-cite-metadata">1 Feb 2011 </div></div>
      
      
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      <div class="highwire-cite-title">MR Imaging of Partially Thrombosed Cerebral Aneurysms: Characteristics and Evolution</div>  
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    	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-oa-ind highwire-cite-metadata"><i class="highwire-oa-indicator"></i> </span><span  class="highwire-cite-metadata-journal highwire-cite-metadata">American Journal of Neuroradiology </span><span  class="highwire-cite-metadata-date highwire-cite-metadata">Feb 2011, </span><span  class="highwire-cite-metadata-volume highwire-cite-metadata">32 </span><span  class="highwire-cite-metadata-issue highwire-cite-metadata">(2) </span><span  class="highwire-cite-metadata-pages highwire-cite-metadata">346-351; </span><span  class="highwire-cite-metadata-doi highwire-cite-metadata"><span class="label">DOI:</span> 10.3174/ajnr.A2298 </span></div>
  
  
  
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