Advanced

AJNR - American Journal of Neuroradiology

This Article Figures Only Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via CrossRef Citing Articles via Google Scholar Google Scholar Articles by Jäger, H. R. Articles by Taylor, W. J. Search for Related Content PubMed PubMed Citation Articles by Jäger, H. R. Articles by Taylor, W. J.

American Journal of Neuroradiology 21:1900-1907 (11 2000)
© 2000 American Society of Neuroradiology

ARTICLE

Contrast-enhanced MR Angiography of Intracranial Giant Aneurysms

H. Rolf Jäger^a,b, Habib Ellamushi^a, Elizabeth A. Moore^a, Joan P. Grieve^a, Neil D. Kitchen^a and Wendy J. Taylor^a

^a From the Lysholm Radiological Department (H.R.J., E.M. W.J.T.), The National Hospital for Neurology and Neurosurgery, and the University Department of Neurosurgery (H.R.J., H.E., J.P.G., N.D.K.), The Institute of Neurology Queen Square, London.
^b Address correspondence to H. Rolf Jäger, Lysholm Radiological Department, The National Hospital for Neurology and Neurosurgery, Queen Square, London WC1N 3BG.

BACKGROUND AND PURPOSE: Intravoxel phase dispersion and flow saturation often prevent adequate depiction of intracranial giant aneurysms on 3D time-of-flight (3D-TOF) MR angiography (MRA). Additional diagnostic difficulties may arise from T1 contamination artifact of an associated blood clot. Our aim was to assess whether contrast-enhanced MRA could improve the evaluation of giant aneurysms and to compare two different types of contrast-enhanced MRA.

METHODS: We studied 11 aneurysms in 10 patients (age range, 31–77 years) with giant aneurysms of the anterior (n = 9) and posterior (n = 2) cerebral circulation by comparing 3D-TOF, first-pass dynamic contrast-enhanced MRA, and steady-state contrast-enhanced 3D-TOF sequences. Additional comparison with digital subtraction angiography (DSA) was performed in eight aneurysms.

RESULTS: In nine of 11 aneurysms, 3D-TOF did not adequately show the lumen and exiting vessels. Contrast-enhanced 3D-TOF and dynamic contrast-enhanced MRA showed the aneurysm sac and exiting vessels in all of these cases. Dynamic contrast-enhanced MRA showed a better intravascular contrast than did contrast-enhanced 3D-TOF, which led to better delineation of the aneurysms. T1 contamination artifact from intra- or extraluminal blood clot was evident on the 3D-TOF images in four cases. The artifact was less marked on the contrast-enhanced 3D-TOF image and was completely eliminated on the dynamic contrast-enhanced MRA image by subtraction of precontrast images. The diagnostic information provided by dynamic contrast-enhanced MRA was comparable to that provided by DSA.

CONCLUSION: Precontrast 3D-TOF is inadequate for the assessment of giant cerebral aneurysms. Both contrast-enhanced 3D-TOF and dynamic contrast-enhanced MRA reliably show the aneurysm sac and connected vessels. Dynamic MRA provides a superior contrast between flow and background and eliminates T1 contamination artifact. It should therefore be considered as the MRA sequence of choice.

This article has been cited by other articles:

				K. Nael, J. P. Villablanca, L. Mossaz, W. Pope, A. Juncosa, G. Laub, and J. P. Finn 3-T Contrast-Enhanced MR Angiography in Evaluation of Suspected Intracranial Aneurysm: Comparison with MDCT Angiography Am. J. Roentgenol., February 1, 2008; 190(2): 389 - 395. [Abstract] [Full Text] [PDF]

				H.A. Deutschmann, M. Augustin, J. Simbrunner, B. Unger, H. Schoellnast, G.A. Fritz, and G.E. Klein Diagnostic Accuracy of 3D Time-of-Flight MR Angiography Compared with Digital Subtraction Angiography for Follow-Up of Coiled Intracranial Aneurysms: Influence of Aneurysm Size AJNR Am. J. Neuroradiol., April 1, 2007; 28(4): 628 - 634. [Abstract] [Full Text] [PDF]

				L. Pierot, C. Delcourt, F. Bouquigny, D. Breidt, B. Feuillet, O. Lanoix, and S. Gallas Follow-up of intracranial aneurysms selectively treated with coils: Prospective evaluation of contrast-enhanced MR angiography. AJNR Am. J. Neuroradiol., April 1, 2006; 27(4): 744 - 749. [Abstract] [Full Text] [PDF]

				C. B. L. M. Majoie, M. E. Sprengers, W. J. J. van Rooij, C. Lavini, M. Sluzewski, J. C. van Rijn, and G. J. den Heeten MR Angiography at 3T versus Digital Subtraction Angiography in the Follow-up of Intracranial Aneurysms Treated with Detachable Coils AJNR Am. J. Neuroradiol., June 1, 2005; 26(6): 1349 - 1356. [Abstract] [Full Text] [PDF]

				J.-P. Cottier, A. Bleuzen-Couthon, S. Gallas, C. B. Vinikoff-Sonier, P. Bertrand, F. Domengie, L. Barantin, and D. Herbreteau Intracranial Aneurysms Treated with Guglielmi Detachable Coils: Is Contrast Material Necessary in the Follow-up with 3D Time-of-Flight MR Angiography? AJNR Am. J. Neuroradiol., October 1, 2003; 24(9): 1797 - 1803. [Abstract] [Full Text] [PDF]

				A. Sungarian, J. Rogg, and J. A. Duncan III Pediatric Intracranial Aneurysm: A Diagnostic Dilemma Solved with Contrast-Enhanced MR Imaging AJNR Am. J. Neuroradiol., March 1, 2003; 24(3): 370 - 372. [Abstract] [Full Text] [PDF]

				X. Leclerc, J.-F. Navez, J.-Y. Gauvrit, J.-P. Lejeune, and J.-P. Pruvo Aneurysms of the Anterior Communicating Artery Treated with Guglielmi Detachable Coils: Follow-Up with Contrast-Enhanced MR Angiography AJNR Am. J. Neuroradiol., August 1, 2002; 23(7): 1121 - 1127. [Abstract] [Full Text] [PDF]

				M. Okahara, H. Kiyosue, M. Yamashita, H. Nagatomi, H. Hata, T. Saginoya, Y. Sagara, and H. Mori Diagnostic Accuracy of Magnetic Resonance Angiography for Cerebral Aneurysms in Correlation With 3D-Digital Subtraction Angiographic Images: A Study of 133 Aneurysms Stroke, July 1, 2002; 33(7): 1803 - 1808. [Abstract] [Full Text] [PDF]