Karsten H Wrede1,2, Toshinori Matsushige3,4,5, Sophia L Goericke6, Bixia Chen3,4, Lale Umutlu6, Harald H Quick3,7, Mark E Ladd3,6,8, Sören Johst3, Michael Forsting6, Ulrich Sure4, Marc Schlamann6,9. 1. Erwin L. Hahn Institute for Magnetic Resonance Imaging, University Duisburg-Essen, 45141, Essen, Germany. karsten.wrede@uk-essen.de. 2. Department of Neurosurgery, University Hospital Essen, Hufelandstrasse 55, 45147, Essen, Germany. karsten.wrede@uk-essen.de. 3. Erwin L. Hahn Institute for Magnetic Resonance Imaging, University Duisburg-Essen, 45141, Essen, Germany. 4. Department of Neurosurgery, University Hospital Essen, Hufelandstrasse 55, 45147, Essen, Germany. 5. Department of Neurosurgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, 734-8553, Hiroshima, Japan. 6. Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, 45147, Essen, Germany. 7. High Field and Hybrid MR Imaging, University Hospital Essen, 45147, Essen, Germany. 8. Division of Medical Physics in Radiology (E020), German Cancer Research Center (DKFZ), 69120, Heidelberg, Germany. 9. Department of Neuroradiology, University Hospital Giessen, 35385, Giessen, Germany.
Abstract
PURPOSE: To prospectively evaluate non-contrast-enhanced 7-Tesla (T) MRA for delineation of unruptured intracranial aneurysms (UIAs) in comparison with DSA. MATERIAL AND METHODS: Forty patients with single or multiple UIAs were enrolled in this IRB-approved trial. Sequences acquired at 7 T were TOF MRA and non-contrast-enhanced MPRAGE. All patients additionally underwent 3D rotational DSA. Two neuroradiologists individually analysed the following aneurysm and image features on a five-point scale in 2D and 3D image reconstructions: delineation of parent vessel, dome and neck; overall image quality; presence of artefacts. Interobserver accordance was assessed by the kappa coefficient. RESULTS: A total of 64 UIAs were detected in DSA and in all 2D and 3D MRA image reconstructions. Ratings showed comparable results for DSA and 7-T MRA when considering all image reconstructions. Highest ratings for individual image reconstructions were given for 2D MPRAGE and 3D TOF MRA. Interobserver accordance was almost perfect for the majority of ratings. CONCLUSION: This study demonstrates excellent delineation of UIAs using 7-T MRA within a clinical setting comparable to the gold standard, DSA. The combination of 7-T non-enhanced MPRAGE and TOF MRA for assessment of untreated UIAs is a promising clinical application of ultra-high-field MRA. KEY POINTS: • Non-enhanced 7-T MRA allowed excellent delineation of unruptured intracranial aneurysms (UIAs). • Image quality at 7-T was comparable with DSA considering both sequences. • Assessment of UIAs is a promising clinical application of ultra-high-field MRA.
PURPOSE: To prospectively evaluate non-contrast-enhanced 7-Tesla (T) MRA for delineation of unruptured intracranial aneurysms (UIAs) in comparison with DSA. MATERIAL AND METHODS: Forty patients with single or multiple UIAs were enrolled in this IRB-approved trial. Sequences acquired at 7 T were TOF MRA and non-contrast-enhanced MPRAGE. All patients additionally underwent 3D rotational DSA. Two neuroradiologists individually analysed the following aneurysm and image features on a five-point scale in 2D and 3D image reconstructions: delineation of parent vessel, dome and neck; overall image quality; presence of artefacts. Interobserver accordance was assessed by the kappa coefficient. RESULTS: A total of 64 UIAs were detected in DSA and in all 2D and 3D MRA image reconstructions. Ratings showed comparable results for DSA and 7-T MRA when considering all image reconstructions. Highest ratings for individual image reconstructions were given for 2D MPRAGE and 3D TOF MRA. Interobserver accordance was almost perfect for the majority of ratings. CONCLUSION: This study demonstrates excellent delineation of UIAs using 7-T MRA within a clinical setting comparable to the gold standard, DSA. The combination of 7-T non-enhanced MPRAGE and TOF MRA for assessment of untreated UIAs is a promising clinical application of ultra-high-field MRA. KEY POINTS: • Non-enhanced 7-T MRA allowed excellent delineation of unruptured intracranial aneurysms (UIAs). • Image quality at 7-T was comparable with DSA considering both sequences. • Assessment of UIAs is a promising clinical application of ultra-high-field MRA.
Entities:
Keywords:
7-T; MPRAGE; Magnetic resonance angiography; Time-of-flight; Unruptured intracranial aneurysm
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