7Tesla MRA for the differentiation between intracranial aneurysms and infundibula

Objective: The differentiation between an aneurysm and an infundibulum with time-of-flight MRA is often difficult. However, this distinction is important because it affects further patient follow-up. The purpose of this study was to assess the added value of high resolution 7Tesla MRA for investigating small vascular lesions suspect for an aneurysm or an infundibulum.

Materials and methods: We included patients in whom an intracranial vascular lesion was detected in our University Hospital and in whom the discrimination between a true aneurysms or an infundibulum could not be made on conventional 1.5 or 3T MRI were included in the study. All patients underwent an additional 7T time-of-flight MRA at higher spatial resolution.

Results: We included 6 patients. The age range of the patients was 35-65years and 5 of them were women. 1 out of 6 had a 1.5T MRI, the other 5 patients had a 3T MRI previous to the 7T MRI. The lesion size varied between 0.9mm and 2.0mm. In 5 of the 6 patients the presence of an infundibulum could be proven using the high resolution of the 7T MRA. All patients tolerated the 7T MRI well.

Conclusion: Our results suggest that high resolution and contrast of 7T MRA provides added diagnostic value in discriminating between intracranial aneurysms and infundibula. This finding may have important consequences for patient follow-up and comfort because it might reduce unnecessary follow-up exams and decrease uncertainty about the diagnosis. Larger studies, however, are needed to confirm our findings.