Ultra-High-Resolution Time-of-Flight MR-Angiography for the Noninvasive Assessment of Intracranial Aneurysms, Alternative to Preinterventional DSA?


Journal

Clinical neuroradiology
ISSN: 1869-1447
Titre abrégé: Clin Neuroradiol
Pays: Germany
ID NLM: 101526693

Informations de publication

Date de publication:
Dec 2023
Historique:
received: 10 12 2022
accepted: 29 05 2023
medline: 27 11 2023
pubmed: 4 7 2023
entrez: 4 7 2023
Statut: ppublish

Résumé

The 3D time-of-flight (TOF) magnetic resonance angiography (MRA) at 3T shows high sensitivity for intracranial aneurysms but is inferior to three-dimensional digital subtraction angiography (3D-DSA) regarding aneurysm characteristics. We applied an ultra-high-resolution (UHR) TOF-MRA using compressed sensing reconstruction to investigate the diagnostic performance in preinterventional evaluation of intracranial aneurysms compared to conventional TOF-MRA and 3D-DSA. In this study 17 patients with unruptured intracranial aneurysms were included. Aneurysm dimensions, configuration, image quality and sizing of endovascular devices were compared between conventional TOF-MRA at 3T and UHR-TOF with 3D-DSA as gold standard. Quantitatively, contrast-to-noise ratios (CNR) were compared between TOF-MRAs. On 3D-DSA, 25 aneurysms in 17 patients were detected. On conventional TOF, 23 aneurysms were detected (sensitivity: 92.6%). On UHR-TOF, 25 aneurysms were detected (sensitivity: 100%). Image quality was not significantly different between TOF and UHR-TOF (p = 0.17). Aneurysm dimension measurements were significantly different between conventional TOF (3.89 mm) and 3D-DSA (4.2 mm, p = 0.08) but not between UHR-TOF (4.12 mm) and 3D-DSA (p = 0.19). Irregularities and small vessels at the aneurysm neck were more frequently correctly depicted on UHR-TOF compared to conventional TOF. Comparison of the planned framing coil diameter and flow-diverter (FD) diameter revealed neither a statistically significant difference between TOF and 3D-DSA (coil p = 0.19, FD p = 0.45) nor between UHR-TOF and 3D-DSA (coil: p = 0.53, FD 0.33). The CNR was significantly higher in conventional TOF (p = 0.009). In this pilot study, ultra-high-resolution TOF-MRA visualized all aneurysms and accurately depicted aneurysm irregularities and vessels at the base of the aneurysm comparably to DSA, outperforming conventional TOF. UHR-TOF with compressed sensing reconstruction seems to represent a non-invasive alternative to pre-interventional DSA for intracranial aneurysms.

Identifiants

pubmed: 37401949
doi: 10.1007/s00062-023-01320-z
pii: 10.1007/s00062-023-01320-z
pmc: PMC10654166
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

1115-1122

Informations de copyright

© 2023. The Author(s).

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Auteurs

Tilman Schubert (T)

Department of Neuroradiology, University Hospital Zurich, Zurich, Switzerland. Tilman.schubert@usz.ch.

Hakim Shakir Husain (HS)

Department of Neuroradiology, University Hospital Zurich, Zurich, Switzerland.
Baby Memorial Hospital, Calicut, Kerala, India.
Parco Institute of Medical Sciences, Vatakara, Kerala, India.
Neo Hospital, Noida, Uttar Pradesh, India.

Patrick Thurner (P)

Department of Neuroradiology, University Hospital Zurich, Zurich, Switzerland.

Jawid Madjidyar (J)

Department of Neuroradiology, University Hospital Zurich, Zurich, Switzerland.

Isabelle Barnaure (I)

Department of Neuroradiology, University Hospital Zurich, Zurich, Switzerland.

Marco Piccirelli (M)

Department of Neuroradiology, University Hospital Zurich, Zurich, Switzerland.

Markus Klarhöfer (M)

Siemens Healthineers, Zurich, Switzerland.

Michaela Schmidt (M)

Siemens Healthineers, Erlangen, Germany.

Peter Speier (P)

Siemens Healthineers, Erlangen, Germany.

Christoph Forman (C)

Siemens Healthineers, Erlangen, Germany.

Zsolt Kulcsar (Z)

Department of Neuroradiology, University Hospital Zurich, Zurich, Switzerland.

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