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Research ArticleINTERVENTIONAL

Usefulness of Silent MR Angiography for Intracranial Aneurysms Treated with a Flow-Diverter Device

H. Oishi, T. Fujii, M. Suzuki, N. Takano, K. Teranishi, K. Yatomi, T. Kitamura, M. Yamamoto, S. Aoki and H. Arai
American Journal of Neuroradiology May 2019, DOI: https://doi.org/10.3174/ajnr.A6047
H. Oishi
aFrom the Departments of Neuroendovascular Therapy (H.O., T.F., T.K.)
bNeurosurgery (H.O., K.T., K.Y., M.Y., H.A.)
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T. Fujii
aFrom the Departments of Neuroendovascular Therapy (H.O., T.F., T.K.)
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M. Suzuki
cRadiology (M.S., N.T., S.A.), Juntendo University Faculty of Medicine, Tokyo, Japan.
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N. Takano
cRadiology (M.S., N.T., S.A.), Juntendo University Faculty of Medicine, Tokyo, Japan.
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K. Teranishi
bNeurosurgery (H.O., K.T., K.Y., M.Y., H.A.)
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K. Yatomi
bNeurosurgery (H.O., K.T., K.Y., M.Y., H.A.)
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T. Kitamura
aFrom the Departments of Neuroendovascular Therapy (H.O., T.F., T.K.)
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M. Yamamoto
bNeurosurgery (H.O., K.T., K.Y., M.Y., H.A.)
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S. Aoki
cRadiology (M.S., N.T., S.A.), Juntendo University Faculty of Medicine, Tokyo, Japan.
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H. Arai
bNeurosurgery (H.O., K.T., K.Y., M.Y., H.A.)
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Abstract

BACKGROUND AND PURPOSE: The flow-diverter device has been established as a treatment procedure for large unruptured intracranial aneurysms. The purpose of this study was to compare the usefulness of Silent MR angiography and time-of-flight MRA to assess the parent artery and the embolization state of the aneurysm after a flow-diverter placement.

MATERIALS AND METHODS: Seventy-eight large, unruptured internal carotid aneurysms in 78 patients were the subjects of this study. After 6 months of treatment, they underwent follow-up digital subtraction angiography, Silent MRA, and TOF-MRA, performed simultaneously. All images were independently reviewed by 2 neurosurgeons and 1 radiologist and rated on a 4-point scale from 1 (not visible) to 4 (excellent) to evaluate the parent artery. The aneurysmal embolization status was assessed with 2 ratings: complete or incomplete occlusion.

RESULTS: The mean scores of Silent MRA and TOF-MRA regarding the parent artery were 3.18 ± 0.72 and 2.31 ± 0.86, respectively, showing a significantly better score with Silent MRA (P < .01). In the assessment of the embolization of aneurysms on Silent MRA and TOF-MRA compared with DSA, the percentages of agreement were 91.0% and 80.8%, respectively.

CONCLUSIONS: Silent MRA is superior for visualizing blood flow images inside flow-diverter devices compared with TOF-MRA. Furthermore, Silent MRA enables the assessment of aneurysmal embolization status. Silent MRA is useful for assessing the status of large and giant unruptured internal carotid aneurysms after flow-diverter placement.

Footnotes

  • Disclosures: Hidenori Oishi—RELATED: Grant: Medtronic, Comments: a donation in the form of a research fund to the endowed chair; Consulting Fee or Honorarium: Medtronic, Comments: More than one million Japanese yen. Shigeki Aoki—UNRELATED: Grants/Grants Pending: Mediphysics, Toshiba, Bayer AG, Daiichi Sankyo, Eisai, Fujiyakuhin, Fujifilm RI, Guerbet, Comments: grant for diagnostic radiology*; Payment for Lectures Including Service on Speakers Bureaus: Mediphysics, Toshiba, Bayer AG, Daiichi Sankyo, Eisai, Fujiyakuhin, Fujifilm RI, Canon, Guerbet, Comments: grant for diagnostic radiology; Payment for Manuscript Preparation: honorarium for lectures/chair from GE Healthcare, Toshiba/Canon, Hitachi, Siemens, Bayer AG, Daiichi Sankyo, Eisai, Fujiyakuhin, Fujifilm RI, Mediphysics, Novartis, Takeda Pharmaceutical Company, Biogen, Chugai Pharmaceutical Co was paid to individual; Payment for Development of Educational Presentations: Gakken Medical Shujunsha, Miwa Shoten Publishers. *Money paid to the institution.

  • This work was supported by Medtronic.

  • © 2019 by American Journal of Neuroradiology
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H. Oishi, T. Fujii, M. Suzuki, N. Takano, K. Teranishi, K. Yatomi, T. Kitamura, M. Yamamoto, S. Aoki, H. Arai
Usefulness of Silent MR Angiography for Intracranial Aneurysms Treated with a Flow-Diverter Device
American Journal of Neuroradiology May 2019, DOI: 10.3174/ajnr.A6047

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Usefulness of Silent MR Angiography for Intracranial Aneurysms Treated with a Flow-Diverter Device
H. Oishi, T. Fujii, M. Suzuki, N. Takano, K. Teranishi, K. Yatomi, T. Kitamura, M. Yamamoto, S. Aoki, H. Arai
American Journal of Neuroradiology May 2019, DOI: 10.3174/ajnr.A6047
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