Case ReportRuptured Cerebral Microaneurysm Diagnosed by 3-Dimensional Fast Spin-Echo T1 Imaging with Variable Flip Angles
Section snippets
History and Examination
A 61-year-old woman presented with a 3-day history of persistent headaches with vomiting. Computed tomography showed SAH localized in the left Sylvian fissure (Fig 1, A). Conventional angiography did not detect any vascular lesion causing SAH (not shown). Three-dimensional rotational angiography showed a small bulge, 1.4 mm in maximum diameter, at the bifurcation of the left middle cerebral artery (MCA; Fig 1, B). CUBE T1 was acquired on a 3T magnetic resonance imaging scanner (Signa HDxt3.0T;
History and Examination
A 41-year-old man presented with complaints of sudden onset of severe headache. Computed tomography demonstrated diffuse SAH that was slightly preponderant in the left basal cistern (Fig 2, A). Conventional angiography did not detect any vascular lesions causing SAH (not shown). Three-dimensional rotational angiography showed a small bulge, 1.5 mm in maximum diameter, at the inferolateral wall of the nonbranching site of the left internal carotid artery (ICA; Fig 1, B). CUBE T1 with Gd
Discussion
Recently, magnetic resonance vessel wall imaging has been reported to be useful in detecting ruptured cerebral aneurysms.5, 6 In these reports, the ruptured aneurysms demonstrated vessel wall enhancement.5, 6 The present cases indicated that ruptured microaneurysms also demonstrated vessel wall enhancement by CUBE T1 sequence. Nagahata et al6 recently investigated precontrast and postcontrast 3-dimensional turbo spin-echo sequence with motion-sensitized driven equilibrium imaging of the 117
Conclusions
CUBE T1 with Gd enhancement is useful as an adjunctive tool for the diagnosis of ruptured cerebral microaneurysms. This sequence might enable neurosurgeons to perform curative surgery with certainty for ruptured microaneurysms.
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