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AJNR - American Journal of Neuroradiology

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American Journal of Neuroradiology 26:2010-2018, September 2005
© 2005 American Society of Neuroradiology

BRAIN

Influence of Perianeurysmal Environment on the Deformation and Bleb Formation of the Unruptured Cerebral Aneurysm: Assessment with Fusion Imaging of 3D MR Cisternography and 3D MR Angiography

Toru Satoh^a, Megumi Omi^b, Chika Ohsako^b, Atsushi Katsumata^c, Yusuke Yoshimoto^c, Shoji Tsuchimoto^c, Keisuke Onoda^d, Koji Tokunaga^d, Kenji Sugiu^d and Isao Date^d

^a Department of Neurological Surgery , Ryofukai Satoh Neurosurgical Hospital, Hiroshima, Japan
^b Department of Diagnostic Radiology , Ryofukai Satoh Neurosurgical Hospital, Hiroshima, Japan
^c Department of Neurological Surgery , Onomichi Municipal Hospital, Japan
^d Department of Neurological Surgery , Okayama University Graduate School of Medicine, Dentistry and Pharmacy, Okayama, Japan

Address correspondence to Toru Satoh, Department of Neurological Surgery, Ryofukai Satoh Neurosurgical Hospital, 5-23-23 Matsunaga, Fukuyama, Hiroshima 729-0104, Japan (e-mail: ucsfbtrc{at}urban.ne.jp)

BACKGROUND AND PURPOSE: Surface irregularity and bleb formation are anatomical factors that are associated with aneurysm rupture. The perianeurysmal environment has been proposed as one factor that may influence aneurysm morphology. We have developed a fusion imaging technique of 3D MR cisternography and angiography that allows clear visualization of an aneurysm and its environment. This technique may prove useful in further understanding of the natural history of intracranial aneurysms.

METHODS: Fusion images of 3D MR cisternography and angiography were reconstructed by a perspective volume-rendering algorithm from the volume datasets of MR cisternography, obtained by a T2-weighted 3D fast spin-echo sequence, and coordinated MR angiography, by a 3D time-of-flight sequence. On the fusion images, the anatomic relationship of an aneurysm to the perianeurysmal structures was assessed, and the influence of perianeurysmal environment on the deformation and bleb formation of the aneurysm was investigated.

RESULTS: Marked and minor deformation and bleb formation of the aneurysmal dome were found at the areas confronted or adjacent to a certain contact with perianeurysmal structures, including cranial nerves, brain parenchyma, cranial base bones, petroclinoidal dural folds, and dura mater.

CONCLUSION: Fusion images of 3D MR cisternography and angiography can depict the contact of an aneurysm with its perianeurysmal environment; this may provide an additional parameter in consideration for the natural history of cerebral aneurysms.

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