INTRODUCTION: Follow-up of intracranial aneurysms treated by embolisation with detachable coils is mandatory to detect a possible recanalisation. The aim of this study was to compare contrast-enhanced magnetic resonance angiography (CE-MRA) with digital substraction angiography (DSA) used to detect aneurysm recanalisation to determine if DSA is still needed during follow-up. MATERIALS AND METHODS: From May 2006 to May 2007, 55 patients with 67 aneurysms were treated by endosaccular coiling with (n = 9) or without (n = 58) an adjunctive stent. Follow-up imaging protocol included MRA at 6 and 12 months and a DSA at 12 months or earlier if a major recanalisation was identified on the 6-month MRA. Two neuroradiologists independently reviewed MRA images (readers 1 and 2) and two other reviewed DSA images. RESULTS: Follow-up DSA showed stability of the aneurysm occlusion in 52 cases, recanalisation in 14 cases, and further thrombosis in one. On CE-MRA, both readers identified all recanalisations but one (sensitivity of 93%) as they missed a major recanalisation in a 2-mm ruptured aneurysm. There were two false-positive evaluations by reader 1 and three for reader 2. Mean specificity of CE-MRA to detect aneurysm recanalisation was 95.5%. CONCLUSION: CE-MRA is accurate to detect aneurysm recanalisation after embolisation with detachable coils. CE-MRA may be proposed as first-intention imaging technique for their follow-up. However, its sensitivity and specificity remain inferior to that of DSA and major recurrences may be missed in very small aneurysms. Therefore, a single DSA remains mandatory during the imaging follow-up.
INTRODUCTION: Follow-up of intracranial aneurysms treated by embolisation with detachable coils is mandatory to detect a possible recanalisation. The aim of this study was to compare contrast-enhanced magnetic resonance angiography (CE-MRA) with digital substraction angiography (DSA) used to detect aneurysm recanalisation to determine if DSA is still needed during follow-up. MATERIALS AND METHODS: From May 2006 to May 2007, 55 patients with 67 aneurysms were treated by endosaccular coiling with (n = 9) or without (n = 58) an adjunctive stent. Follow-up imaging protocol included MRA at 6 and 12 months and a DSA at 12 months or earlier if a major recanalisation was identified on the 6-month MRA. Two neuroradiologists independently reviewed MRA images (readers 1 and 2) and two other reviewed DSA images. RESULTS: Follow-up DSA showed stability of the aneurysm occlusion in 52 cases, recanalisation in 14 cases, and further thrombosis in one. On CE-MRA, both readers identified all recanalisations but one (sensitivity of 93%) as they missed a major recanalisation in a 2-mm ruptured aneurysm. There were two false-positive evaluations by reader 1 and three for reader 2. Mean specificity of CE-MRA to detect aneurysm recanalisation was 95.5%. CONCLUSION: CE-MRA is accurate to detect aneurysm recanalisation after embolisation with detachable coils. CE-MRA may be proposed as first-intention imaging technique for their follow-up. However, its sensitivity and specificity remain inferior to that of DSA and major recurrences may be missed in very small aneurysms. Therefore, a single DSA remains mandatory during the imaging follow-up.
Authors: Charles B L M Majoie; Marieke E Sprengers; Willem Jan J van Rooij; Cristina Lavini; Menno Sluzewski; Jeroen C van Rijn; Gerard J den Heeten Journal: AJNR Am J Neuroradiol Date: 2005 Jun-Jul Impact factor: 3.825
Authors: M R Mayberg; H H Batjer; R Dacey; M Diringer; E C Haley; R C Heros; L L Sternau; J Torner; H P Adams; W Feinberg Journal: Stroke Date: 1994-11 Impact factor: 7.914
Authors: N Anzalone; C Righi; F Simionato; F Scomazzoni; G Pagani; G Calori; P Santino; G Scotti Journal: AJNR Am J Neuroradiol Date: 2000-04 Impact factor: 3.825
Authors: Andrew J Molyneux; Richard S C Kerr; Ly-Mee Yu; Mike Clarke; Mary Sneade; Julia A Yarnold; Peter Sandercock Journal: Lancet Date: 2005 Sep 3-9 Impact factor: 79.321
Authors: M J van Amerongen; H D Boogaarts; J de Vries; A L M Verbeek; F J A Meijer; M Prokop; R H M A Bartels Journal: AJNR Am J Neuroradiol Date: 2013-09-05 Impact factor: 3.825
Authors: Thomas Westermaier; Nadine Willner; Giles H Vince; Thomas Linsenmann; Ralf-Ingo Ernestus; Christian Stetter Journal: Emerg Radiol Date: 2014-07-03
Authors: Guilherme S Nakiri; Antonio C Santos; Thiago G Abud; Davi C Aragon; Benedicto O Colli; Daniel G Abud Journal: Clinics (Sao Paulo) Date: 2011 Impact factor: 2.365