Time-of-Flight Magnetic Resonance Angiography for Follow-Up of Coil Embolization with Enterprise Stent for Intracranial Aneurysm: Usefulness of Source Images.
10.3348/kjr.2014.15.1.161
- Author:
Young Dae CHO
1
;
Kang Min KIM
;
Woong Jae LEE
;
Chul Ho SOHN
;
Hyun Seung KANG
;
Jeong Eun KIM
;
Moon Hee HAN
Author Information
1. Department of Radiology, Seoul National University College of Medicine, Seoul 110-744, Korea.
- Publication Type:Original Article
- Keywords:
Aneurysm;
Coiling;
Embolization;
Stent;
MRA
- MeSH:
Angiography, Digital Subtraction/methods;
Cerebral Angiography/methods;
Embolization, Therapeutic/instrumentation/*methods;
Female;
Follow-Up Studies;
Humans;
Intracranial Aneurysm/diagnosis/radiography/*therapy;
Magnetic Resonance Angiography/*methods;
Male;
Middle Aged;
Observer Variation;
Recurrence;
Reference Standards;
*Stents
- From:Korean Journal of Radiology
2014;15(1):161-168
- CountryRepublic of Korea
- Language:English
-
Abstract:
OBJECTIVE: The aim of this study was to determine the interobserver and intermodality agreement in the interpretation of time-of-flight (TOF) MR angiography (MRA) for the follow-up of coiled intracranial aneurysms with the Enterprise stent. MATERIALS AND METHODS: Two experienced neurointerventionists independently reviewed the follow-up MRA studies of 40 consecutive patients with 44 coiled aneurysms. All aneurysms were treated with assistance from the Enterprise stent and the radiologic follow-up intervals were greater than 6 months after the endovascular therapy. Digital subtraction angiography (DSA) served as the reference standard. The degree of aneurysm occlusion was determined by an evaluation of the maximal intensity projection (MIP) and source images (SI) of the TOF MRA. The capability of the TOF MRA to depict the residual flow within the coiled aneurysms and the stented parent arteries was compared with that of the DSA. RESULTS: DSA showed stable occlusions in 25 aneurysms, minor recanalization in 8, and major recanalization in 11. Comparisons between the TOF MRA and conventional angiography showed that the MIP plus SI had almost perfect agreement (kappa = 0.892, range 0.767 to 1.000) and had better agreement than with the MIP images only (kappa = 0.598, range 0.370 to 0.826). In-stent stenosis of more than 33% was observed in 5 cases. Both MIP and SI of the MRA showed poor depiction of in-stent stenosis compared with the DSA. CONCLUSION: TOF MRA seemed to be reliable in screening for aneurysm recurrence after coil embolization with Enterprise stent assistance, especially in the evaluation of the SI, in addition to MIP images in the TOF MRA.
