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RT Journal Article
SR Electronic
T1 MR Angiographic Follow-Up of Intracranial Aneurysms Treated with Detachable Coils: Evaluation of a Blood-Pool Contrast Medium
JF American Journal of Neuroradiology
JO Am. J. Neuroradiol.
FD American Society of Neuroradiology
SP 1524
OP 1530
DO 10.3174/ajnr.A1622
VO 30
IS 8
A1 Kau, T.
A1 Gasser, J.
A1 Celedin, S.
A1 Rabitsch, E.
A1 Eicher, W.
A1 Uhl, E.
A1 Hausegger, K.A.
YR 2009
UL http://www.ajnr.org/content/30/8/1524.abstract
AB BACKGROUND AND PURPOSE: Blood-pool agents are promising in the imaging of small vessels with slow or complex flow. Our aim was to compare blood-pool contrast-enhanced MR angiography (BPCE-MRA) using gadofosveset trisodium (Vasovist) with 3D time-of-flight MRA (TOF-MRA) in the follow-up of intracranial aneurysms after endovascular therapy. MATERIALS AND METHODS: We included 32 patients with a total of 37 coiled aneurysms. MRAs in the early steady-state phase were performed on a 1.5T scanner within 8 days of digital subtraction angiography (DSA). Two radiologists independently analyzed TOF-MRA and BPCE-MRA images. Consensus was reached by review involving a third neuroradiologist. DSA images were interpreted separately by an interventional radiologist. Findings were assigned to 1 of 3 categories: 1) complete occlusion, 2) residual neck, and 3) residual aneurysm. RESULTS: Follow-up DSA demonstrated 13 complete obliterations (class 1), 13 residual necks (class 2), and 11 residual aneurysms (class 3). Weighted κ statistics showed substantial concordance of TOF-MRA and DSA (0.664) as well as BPCE-MRA and DSA (0.724) ratings. Comparison between TOF-MRA and BPCE-MRA found excellent agreement (0.818) with only 6 (16.2%) discrepancies. For detecting residual flow, the difference in accuracy of both MRA techniques (83.8% versus 91.9%) was not significant (McNemar, P = 1.000). BPCE-MRA showed a tendency towards higher sensitivity and specificity (91.7% and 92.3%, respectively) compared with TOF-MRA (87.5% and 76.9%). CONCLUSIONS: In classifying the completeness of endovascular cerebral aneurysm therapy, we found that BPCE-MRA and 3D TOF-MRA showed very good agreement. The use of Vasovist did not lead to a significantly increased accuracy of MRA follow-up.