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Non-enhanced magnetic resonance imaging of unruptured intracranial aneurysms at 7 Tesla: Comparison with digital subtraction angiography

  • Magnetic Resonance
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Abstract

Purpose

To prospectively evaluate non-contrast-enhanced 7-Tesla (T) MRA for delineation of unruptured intracranial aneurysms (UIAs) in comparison with DSA.

Material and methods

Forty patients with single or multiple UIAs were enrolled in this IRB-approved trial. Sequences acquired at 7 T were TOF MRA and non-contrast-enhanced MPRAGE. All patients additionally underwent 3D rotational DSA. Two neuroradiologists individually analysed the following aneurysm and image features on a five-point scale in 2D and 3D image reconstructions: delineation of parent vessel, dome and neck; overall image quality; presence of artefacts. Interobserver accordance was assessed by the kappa coefficient.

Results

A total of 64 UIAs were detected in DSA and in all 2D and 3D MRA image reconstructions. Ratings showed comparable results for DSA and 7-T MRA when considering all image reconstructions. Highest ratings for individual image reconstructions were given for 2D MPRAGE and 3D TOF MRA. Interobserver accordance was almost perfect for the majority of ratings.

Conclusion

This study demonstrates excellent delineation of UIAs using 7-T MRA within a clinical setting comparable to the gold standard, DSA. The combination of 7-T non-enhanced MPRAGE and TOF MRA for assessment of untreated UIAs is a promising clinical application of ultra-high-field MRA.

Key Points

• Non-enhanced 7-T MRA allowed excellent delineation of unruptured intracranial aneurysms (UIAs).

• Image quality at 7-T was comparable with DSA considering both sequences.

• Assessment of UIAs is a promising clinical application of ultra-high-field MRA.

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Abbreviations

7-T:

7-Tesla

CNR:

Contrast-to-noise ratio

DSA:

Digital subtraction angiography

FWER:

Familywise error rate

GRAPPA:

Generalized Autocalibrating Partial Parallel Acquisition

MPRAGE:

Magnetization-prepared rapid acquisition gradient-echo

MRA:

Magnetic resonance angiography

PACS:

Picture Archiving and Communication System

RF:

Radiofrequency

SAH:

Subarachnoid haemorrhage

SEM:

Standard error of mean

SNR:

Signal-to-noise ratio

TOF:

Time-of-flight

TONE:

Tilt-optimized non-saturated excitation

UIA:

Unruptured intracranial aneurysm

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Acknowledgements

The scientific guarantor of this publication is Dr. Karsten H. Wrede. The authors of this manuscript declare no relationships with any companies whose products or services may be related to the subject matter of the article. This study has received funding by University Duisburg Essen (IFORES grant). Dr. Ulrike Krahn kindly provided statistical advice for this manuscript. Institutional Review Board approval was obtained. Written informed consent was obtained from all subjects (patients) in this study. Methodology: prospective, observational, multicentre study.

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Authors and Affiliations

  1. Erwin L. Hahn Institute for Magnetic Resonance Imaging, University Duisburg-Essen, 45141, Essen, Germany

    Karsten H. Wrede, Toshinori Matsushige, Bixia Chen, Harald H. Quick, Mark E. Ladd & Sören Johst

  2. Department of Neurosurgery, University Hospital Essen, Hufelandstrasse 55, 45147, Essen, Germany

    Karsten H. Wrede, Toshinori Matsushige, Bixia Chen & Ulrich Sure

  3. Department of Neurosurgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, 734-8553, Hiroshima, Japan

    Toshinori Matsushige

  4. Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, 45147, Essen, Germany

    Sophia L. Goericke, Lale Umutlu, Mark E. Ladd, Michael Forsting & Marc Schlamann

  5. High Field and Hybrid MR Imaging, University Hospital Essen, 45147, Essen, Germany

    Harald H. Quick

  6. Division of Medical Physics in Radiology (E020), German Cancer Research Center (DKFZ), 69120, Heidelberg, Germany

    Mark E. Ladd

  7. Department of Neuroradiology, University Hospital Giessen, 35385, Giessen, Germany

    Marc Schlamann

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  1. Karsten H. Wrede
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Correspondence to Karsten H. Wrede.

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Wrede, K.H., Matsushige, T., Goericke, S.L. et al. Non-enhanced magnetic resonance imaging of unruptured intracranial aneurysms at 7 Tesla: Comparison with digital subtraction angiography. Eur Radiol 27, 354–364 (2017). https://doi.org/10.1007/s00330-016-4323-5

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  • DOI: https://doi.org/10.1007/s00330-016-4323-5

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