Abstract
BACKGROUND AND PURPOSE: Endovascular treatment of intracranial aneurysms aims at preventing aneurysm rupture. Contrast-enhanced black-blood MR imaging facilitates imaging of the vessel walls and the aneurysmal sac contents and is therefore suitable for studying the healing process. This study aims to describe imaging findings of aneurysmal contrast enhancement following endovascular treatment and its correlation to recurrence and elapsed time since coiling.
MATERIALS AND METHODS: Patients undergoing MR imaging follow-up after endovascular treatment of an intracranial aneurysm were included. Contrast-enhanced black-blood T1WI was acquired. Aneurysm wall and intra-aneurysmal enhancement were independently assessed by 2 neuroradiologists and were related to the time elapsed since coiling and the presence of recurrence.
RESULTS: Thirty aneurysms in 30 patients were included. The median time elapsed since treatment was 417 days (interquartile range, 189–1273 days). Aneurysmal contrast enhancement was seen in 24/30 (80%) aneurysms. Enhancement inside the sac in 55% (n = 17), the wall in 23% (n = 7), at the dome (n = 1), or at the base (n = 6) was observed. No statistically significant correlation between aneurysmal contrast enhancement and the elapsed time (P = .83) and presence of a recurrence (P = .184) was detected. In 28/30 patients, the images were of adequate diagnostic quality. Stent implants caused negligible image artifacts.
CONCLUSIONS: Intra-aneurysmal contrast enhancement following endovascular treatment of intracranial aneurysms is a common finding and likely reflects the healing process. A long-term study to examine changes occurring with time and their association with packing density, type of coils (bare platinum versus bioactive coils), and aneurysm recurrence is underway (German Clinical Trials Register, DRKS-ID: DRKS00014644).
Footnotes
Paper previously presented at: Annual Meeting of the German Society of Neuroradiology, October 3–6, 2018; Frankfurt, Germany.
This work was supported by the Research Committee, Albert-Ludwigs-Universität Freiburg.
Disclosures: Samer Elsheikh—RELATED: Grant: Research Committee, Faculty of Medicine, University of Freiburg, Freiburg, Germany*; UNRELATED: Grants/Grants Pending: Bracco SpA, Comments: research funding for another research article concerned with contrast enhancement of unrupruted aneurysms, not yet published.* Horst Urbach—UNRELATED: Board Membership: Co-Editor of Clinical Neuroradiology, Editorial Board of Neuroradiology, Comments: 1000 €/year; Payment for Lectures Including Service on Speakers Bureaus: Bayer AG, Bracco SpA, Stryker, UCB Pharma, Comments: less than 10,000 € since 2016; Other: shareholder of VEObrain GmbH, Comments: no money paid. Stephan Meckel—RELATED: Grant: Bracco SpA*; UNRELATED: Board Membership: Acandis GmbH, Comments: modest consultant’s fee as member of the Scientific Advisory Board; Consultancy: Novartis Pharma GmbH, Comments: modest consultant’s fee; Grants/Grants Pending: Novartis Pharma GmbH, Comments: MR imaging study grant*; Payment for Lectures Including Service on Speakers Bureaus: Medtronic, Comments: modest lecture fee; Payment for Development of Educational Presentations: Medtronic, Comments: money from Medtronic was paid to an individual; Travel/Accommodations/Meeting Expenses Unrelated to Activities Listed: Balt/AB Medica, MicroVention, Stryker.* *Money paid to the institution.
- © 2020 by American Journal of Neuroradiology