scholarly journals Utility of Contrast-Enhanced Magnetic Resonance Angiography for Delayed Intracranial In-Stent Stenosis in Nonatherosclerotic Cerebral Vascular Diseases

2017 ◽  
Vol 01 (02) ◽  
pp. 085-088
Author(s):  
Santhosh Kannath ◽  
Jayadevan Rajan ◽  
Kamble Harsha
Keyword(s):  
Magnetic Resonance ◽  
Magnetic Resonance Angiography ◽  
Vascular Diseases ◽  
Source Image ◽  
Tof Mra ◽  
Contrast Enhanced ◽  
Long Term Follow Up ◽  
Image Set ◽  
Stent Stenosis

AbstractNoninvasive imaging modalities are being used for long-term follow-up of intracranial stented patients of nonatherosclerotic etiology. The aim of this study is to determine the utility of contrast-enhanced magnetic resonance angiography (CE-MRA) source images in delayed intracranial in-stent stenosis. A total of 18 stented patients for nonatherosclerotic etiology were reviewed; all had follow-up digital subtraction angiography (DSA) and CE- and time-of-flight (TOF)-MRA. Four sets of MR images (TOF-MRA reformatted images, TOF-MRA source images, CE-MRA reformatted images, and CE-MRA source images) were reviewed for detection of ≥ 50% stenosis. Accuracy of each image set was calculated comparing to DSA. Overall delayed in-stent stenosis during follow-up DSA was 10%. The sensitivity of TOF reformatted image, TOF source image, CE-MRA reformatted image, CE-MRA source image are 33% (6/18), 55.6% (10/18), 77.8% (14/18), and 100% (18/18), respectively, while negative predictive value are 14.3% (2/14), 20% (2/10), 33% (2/6), and 100% (2/2), respectively. CE-MRA source images are equally efficacious as DSA to detect significant (≥ 50%) delayed in-stent stenosis.

scholarly journals The implications of magnetic resonance angiography artifacts caused by different types of intracranial flow diverters

2021 ◽  
Vol 23 (1) ◽  
Author(s):  
Batur Halitcan ◽  
Sayin Bige ◽  
Balci Sinan ◽  
Akmangit Ilkay ◽  
Daglioglu Ergun ◽  
...  
Keyword(s):  
Magnetic Resonance ◽  
Magnetic Resonance Angiography ◽  
Predictive Value ◽  
Diagnostic Yield ◽  
Flow Diverter ◽  
Parent Artery ◽  
Perfect Agreement ◽  
Tof Mra ◽  
Flow Diverters

Abstract Background Serial cerebral angiographic imaging is necessary to ensure cerebral aneurysm occlusion after flow diverter placement. Time-of-flight (TOF)-magnetic resonance angiography (MRA) is used for this purpose due to its lack of radiation, contrast media and complications. The comparative diagnostic yield of TOF-MRA for different flow diverters has not been previously analyzed. Purpose To evaluate the diagnostic accuracy of TOF-MRA in cerebral aneurysms treated w divertersith different flow diverters. Materials and Methods Flow-diverted patients whose cerebral follow-up MRA and digital subtraction angiograms (DSA) were obtained within 6 weeks were retrospectively identified. The DSA (as gold standard) and MRA images of these patients were compared by two readers (blinded to both patient data and endovascular procedure data) for residual aneurysms and the status of the parent artery for each type of flow diverter. In a second group of patients, magnetic susceptibility artifacts were manually measured and compared for different FDs. Results Seventy-six patients (85 aneurysms) were included in group one, and 86 patients (95 aneurysms) were included in group 2. TOF-MRA and DSA showed almost perfect agreement for residual aneurysms (κ = 0.88, p < 0.001) (positive predictive value (PPV) = 1.00, specificity = 1.00, negative predictive value (NPV) = 0.89, sensitivity = 0.89). Intermodality agreement (κ = 0.97 vs. κ = 0.74, p < 0.005) and sensitivity (0.97 vs. 0.77, NPV: 0.96 vs. 0.77) were highest with nitinol stents. MRA and DSA showed no agreement for occluded or stenotic parent vessels (κ = 0.13, p = 0.015, specificity = 0.44, NPV = 1.00, sensitivity = 1.00). Specificity was lower in chromium-cobalt based FDs than in nitinol devices (specificity = 0.08 vs. 0.60). Chromium-cobalt stents generated the largest artifacts (p < 0.005). The size of the device-related artifact, in millimeters, increased in respective order, for the Silk, Derivo, Pipeline and Surpass devices. Conclusion Unlike DSA, TOF-MRA is susceptible to dissimilarities between flow diverters. MRA is not well-suited for research studies comparing different flow diverters. Nitinol FDs appear to be advantageous for TOF-MRA follow-up so as not to miss small aneurysm remnants or clinically relevant parent artery stenosis.

DYNAMIC CONTRAST-ENHANCED MAGNETIC RESONANCE ANGIOGRAPHY OF Gd-TTDA-BOM COMPARED WITH Gd-DTPA IN NORMAL RAT AT 3T

2014 ◽  
Vol 26 (02) ◽  
pp. 1450027
Author(s):  
Jo-Chi Jao ◽  
Yen-Ku Chen ◽  
Twei-Shiun Jaw ◽  
Yun-Ming Wang ◽  
Po-Chou Chen
Keyword(s):  
Magnetic Resonance ◽  
Magnetic Resonance Angiography ◽  
Vascular Diseases ◽  
Signal Enhancement ◽  
Dynamic Contrast Enhanced ◽  
Contrast Enhanced ◽  
Normal Rat ◽  
Reorientation Time ◽  
Phantom Studies

Dynamic contrast-enhanced magnetic resonance angiography (DCE-MRA) is a good modality for the diagnosis of vascular diseases. Contrast agents that produce higher and longer enhancement in vessels are highly valued. The complex of gadolinium with (R,S)-4-carboxy-5,9,12-tris(carboxymethyl)-l-phenyl-2-oxa-5,9,12-triazatridecan-14-oic acid (Gd-TTDA-BOM) possesses a benzyloxymethyl group in the ligand TTDA-BOM with the capability of raising lipophilicity. The Gd-TTDA-BOM complex expresses higher and longer enhancement in mouse liver than that of gadolinium diethylenetriamine pentaacetic acid (Gd-DTPA) because of its faster water exchange rate, higher reorientation time, and higher lipophilicity. Phantom studies have shown that Gd-TTDA-BOM has expressed with higher affinity to human serum albumin (HSA) than Gd-DTPA. In general, these characteristics might provide an advantage for vascular imaging. To verify this in vivo, a 3T MR scanner was used to investigate the signal enhancement in the aorta of normal rats by DCE-MRA after the bolus injection of Gd-TTDA-BOM and compared this with the injection of Gd-DTPA. Gd-TTDA-BOM expressed higher and longer signal enhancement in the aorta than Gd-DTPA. These results suggest that Gd-TTDA-BOM could provide better image quality than Gd-DTPA as an enhancement agent in DCE-MRA.

Delayed Contrast-Enhanced Magnetic Resonance Imaging For the Detection of Autoimmune Myocarditis and Long-term Follow-Up

2005 ◽  
Vol 7 (2) ◽  
pp. 521-523 ◽  
Author(s):  
Thorsten Dill ◽  
Okan Ekinci ◽  
Jochen Hansel ◽  
Alexander Kluge ◽  
Christiane Breidenbach ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Resonance Imaging ◽  
Autoimmune Myocarditis ◽  
Contrast Enhanced ◽  
Long Term Follow Up
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