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Three-dimensional time-of-flight MR angiography at 3 T compared to digital subtraction angiography in the follow-up of ruptured and coiled intracranial aneurysms: a prospective study

  • Diagnostic Neuroradiology
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Abstract

Introduction

Since digital subtraction angiography (DSA) carries a low risk of morbidity, and is associated with patient discomfort and higher cost, our objective was to determine whether high-resolution 3-D time-of-flight MR angiography (TOF-MRA) at 3 T may replace DSA in the follow-up of patients after coiling of an intracranial aneurysm.

Methods

This prospective study included 50 consecutive patients with a ruptured and subsequently coiled intracranial aneurysm. All patients were followed up at a mean of 14 months after coiling with DSA and high-resolution 3-D TOF-MRA at 3 T generating 0.02 mm3 isotropic voxels. One examiner used DSA and TOF-MR angiograms to assess the need for and risk of retreatment; these data were used to calculate intermodality agreement. Another two examiners independently assessed aneurysm occlusion by DSA and TOF-MRA according to the Raymond scale; these data were used to calculate interobserver agreement.

Results

Discrepancies between DSA and TOF-MRA were found in three patients (intermodality agreement κ = 0.86). While DSA indicated complete aneurysm occlusion, TOF-MRA showed small neck remnants in the three patients. Coils on all DSA projections obscured these three neck remnants. Interobserver agreement was higher for DSA (κ = 0.82) than for TOF-MRA (κ = 0.68), which was in part due to the complexity of the information provided by TOF source images and reconstructions.

Conclusion

3-D TOF-MRA at 3 T is not only an adjunctive tool but is ready to replace DSA in the follow-up of patients with previously coiled intracranial aneurysms. Additional DSA may only be performed in complex and not clearly laid out aneurysms.

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Conflict of interest statement

We declare that we have no conflict of interest.

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Authors and Affiliations

  1. Department of Radiology, University of Bonn Medical Centre, Bonn, Germany

    H. Urbach, U. Dorenbeck, M. von Falkenhausen, K. Wilhelm, W. Willinek & S. Flacke

  2. Department of Neurosurgery, University of Bonn Medical Centre, Bonn, Germany

    C. Schaller

  3. Department of Radiology/Neuroradiology, University of Bonn Medical Centre, Sigmund Freud Str. 25, 53105, Bonn, Germany

    H. Urbach

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  1. H. Urbach
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  2. U. Dorenbeck
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  3. M. von Falkenhausen
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Correspondence to H. Urbach.

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Urbach, H., Dorenbeck, U., von Falkenhausen, M. et al. Three-dimensional time-of-flight MR angiography at 3 T compared to digital subtraction angiography in the follow-up of ruptured and coiled intracranial aneurysms: a prospective study. Neuroradiology 50, 383–389 (2008). https://doi.org/10.1007/s00234-007-0355-5

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