Usefulness of pointwise encoding time reduction with radial acquisition sequence in subtraction-based magnetic resonance angiography for follow-up of the Neuroform Atlas stent-assisted coil embolization for cerebral aneurysms

2020 ◽  
pp. 028418512095278
Author(s):  
Young Jin Heo ◽  
Hae Woong Jeong ◽  
Donghyun Kim ◽  
Jin Wook Baek ◽  
Ji-yeon Han ◽  
...  
Keyword(s):  
Magnetic Resonance ◽  
Magnetic Resonance Angiography ◽  
Coil Embolization ◽  
Intracranial Aneurysms ◽  
Alternative Methods ◽  
Radial Acquisition ◽  
Tof Mra ◽  
Significant Difference ◽  
Time Reduction

Background Although time-of-flight magnetic resonance angiography (TOF-MRA) is widely used, it has limited usefulness for follow-up after stent-assisted coil embolization. Contrast-enhanced MRA (CE-MRA) and ultrashort echo time MRA have been suggested as alternative methods for visualization after this procedure. Purpose To compare efficacy and usefulness of pointwise encoding time reduction with radial acquisition (PETRA) sequence in subtraction-based MRA (qMRA), TOF-MRA, and CE-MRA during the follow-up after Neuroform Atlas stent-assisted coil embolization for intracranial aneurysms. Material and Methods This retrospective study included 23 patients with 24 aneurysms who underwent Neuroform Atlas stent-assisted coil embolization for intracranial aneurysms. All patients were evaluated with PETRA qMRA, TOF-MRA, and CE-MRA at the same follow-up session. The flow within stents, occlusion status, and presence of pseudo-stenosis were evaluated; inter-observer and intermodality agreements for the three methods were also graded. Results The mean score for flow visualization within the stents was significantly higher for PETRA qMRA and CE-MRA than for TOF-MRA (although no significant difference was found between PETRA qMRA and CE-MRA). Good inter-observer agreement was observed for each modality. PETRA qMRA and CE-MRA were more consistent with digital subtraction angiography (DSA) than TOF-MRA for aneurysm occlusion status. The intermodality agreement was better between PETRA qMRA and DSA, and between CE-MRA and DSA, than between DSA and TOF-MRA. Pseudo-stenosis was most frequently observed in TOF-MRA, followed by CE-MRA and PETRA qMRA. Conclusion PETRA qMRA is useful for evaluating the parent artery patency and occlusion status of aneurysms after Neuroform Atlas stent-assisted coil embolization.

Usefulness of Noncontrast-Enhanced Silent Magnetic Resonance Angiography (MRA) for Treated Intracranial Aneurysm Follow-up in Comparison with Time-of-Flight MRA

Neurosurgery ◽  
2019 ◽  
Vol 87 (2) ◽  
pp. 220-228 ◽  
Author(s):  
Kyeong Hwa Ryu ◽  
Hye Jin Baek ◽  
Jin Il Moon ◽  
Bo Hwa Choi ◽  
Sung Eun Park ◽  
...  
Keyword(s):  
Magnetic Resonance ◽  
Magnetic Resonance Angiography ◽  
Intracranial Aneurysms ◽  
Diagnostic Performance ◽  
Interobserver Agreement ◽  
Curve Analysis ◽  
Roc Curve Analysis ◽  
Tof Mra ◽  
Treated Site

Abstract BACKGROUND Flow visualization in time-of-flight magnetic resonance angiography (TOF MRA) is limited for treated intracranial aneurysms owing to magnetic susceptibility and radiofrequency shielding. OBJECTIVE To assess the clinical usefulness of noncontrast-enhanced magnetic resonance angiography (MRA) using a silent scan (silent MRA) as a follow-up imaging modality in patients with treated intracranial aneurysms. METHODS A total of 119 patients with 126 treated aneurysms underwent silent MRA and TOF MRA during the same scan session. Two neuroradiologists independently assessed overall image quality and visualization of the treated site using a 5-point Likert scale to compare the 2 image sets. We used receiver operating characteristic (ROC) curve analysis to investigate the diagnostic performance of the 2 MRA methods in evaluating aneurysm occlusion. Interobserver reliability was also assessed using weighted kappa statistics. RESULTS The overall image quality scores of silent MRA and TOF MRA were 4.04 ± 0.22 and 4.64 ± 0.48, respectively (P < .001), and interobserver agreement was substantial (P < .001). For the treated site, the score of flow visualization on silent MRA was higher than that on TOF MRA, 3.94 ± 0.94 vs 2.59 ± 1.37 (P < .001), with substantial interobserver agreement (P < .001). ROC curve analysis showed that silent MRA was superior to TOF MRA in diagnostic performance (area under the curve [AUC] = 0.962; 95% CI: 0.931-0.982 vs AUC = 0.843; 95% CI: 0.792-0.886; P < .001). CONCLUSION Silent MRA can be useful to evaluate treated intracranial aneurysms during follow-up without radiation exposure and use of contrast material. It is characterized by higher diagnostic performance and superior visualization for the treated site.

Usefulness of Pointwise Encoding Time Reduction with Radial Acquisition-Magnetic Resonance Angiography after Endovascular Treatment for Intracranial Aneurysms

2021 ◽  
pp. 159101992110659
Author(s):  
Young Jin Heo ◽  
Donghyun Kim ◽  
Hae Woong Jeong ◽  
Jin Wook Baek ◽  
Da Som Kim ◽  
...  
Keyword(s):  
Magnetic Resonance ◽  
Magnetic Resonance Angiography ◽  
Endovascular Treatment ◽  
Diagnostic Performance ◽  
Time Of Flight ◽  
Posterior Circulation ◽  
Radial Acquisition ◽  
Posterior Circulation Aneurysms ◽  
Time Reduction

Purpose Imaging follow-up after endovascular treatment is important; however, time-of-flight magnetic resonance angiography (TOF-MRA) has limitations associated with magnetic susceptibility and radiofrequency shielding caused by the stent and coils. We evaluated the diagnostic performance of pointwise encoding time reduction with radial acquisition (PETRA)-MRA after endovascular treatment for intracranial aneurysms. Material and methods A total of 186 patients with 211 aneurysms who underwent both pointwise encoding time reduction with radial acquisition- and time-of-flight magnetic resonance angiography in the same imaging session for follow-up after endovascular treatment. We subjectively graded the overall image quality, visualization of treated sites, and occlusion status. Results Although the overall image quality scores of pointwise encoding time reduction with radial acquisition-magnetic resonance angiography were significantly lower than those of time-of-flight magnetic resonance angiography for both observers (4.04 ± 0.81 vs. 4.85 ± 0.35 [observer 1], 4.60 ± 0.69 vs. 4.94 ± 0.24 [observer 2]) (both P < .001), the visibility of treated sites using pointwise encoding time reduction with radial acquisition-magnetic resonance angiography was significantly better than that of time-of-flight magnetic resonance angiography overall (4.27 ± 0.97 vs. 3.42 ± 1.01; P < .001), in the distal internal carotid artery (4.46 ± 0.79 vs. 3.40 ± 1.00; P < .001), and in the middle cerebral artery (4.19 ± 0.93 vs. 3.08 ± 0.53, P = 0.007). Pointwise encoding time reduction with radial acquisition-magnetic resonance angiography showed a higher area under the curve than time-of-flight magnetic resonance angiography for the evaluation of treated aneurysm occlusion, except for posterior circulation aneurysms. Conclusions Pointwise encoding time reduction with radial acquisition-magnetic resonance angiography showed better visualization of treated sites and better diagnostic performance than time-of-flight magnetic resonance angiography for anterior circulation aneurysms. However, Pointwise encoding time reduction with radial acquisition-magnetic resonance angiography showed limitations in the follow-up evaluation of posterior circulation aneurysms.

Ultrashort Echo Time Magnetic Resonance Angiography in Follow-up of Intracranial Aneurysms Treated With Endovascular Coiling: Comparison of Time-of-Flight, Pointwise Encoding Time Reduction With Radial Acquisition, and Contrast-Enhanced Magnetic Resonance Angiography

Neurosurgery ◽  
2020 ◽  
Author(s):  
Sung-Hye You ◽  
Byungjun Kim ◽  
Kyung-Sook Yang ◽  
Bo Kyu Kim ◽  
Jaeil Ryu
Keyword(s):  
Magnetic Resonance ◽  
Magnetic Resonance Angiography ◽  
Diagnostic Performance ◽  
Time Of Flight ◽  
Endovascular Coiling ◽  
Residual Flow ◽  
Radial Acquisition ◽  
Contrast Enhanced ◽  
Aneurysm Occlusion ◽  
Time Reduction

Abstract BACKGROUND The optimal magnetic resonance angiography (MRA) sequence for assessing the aneurysm occlusion state or in-stent flow after endovascular coiling is not well established. OBJECTIVE To evaluate the diagnostic performance of pointwise encoding time reduction with radial acquisition (PETRA)-MRA in patients who underwent endovascular coiling relative to that of time-of-flight (TOF)-MRA and contrast-enhanced (CE)-MRA. METHODS We evaluated the aneurysm occlusion state using digital subtraction angiography (DSA) and MRA. In patients who underwent stent-assisted coiling, we estimated the visibility of in-stent flow. RESULTS We enrolled 189 patients with assessable TOF, PETRA, and CE-MRAs after coiling. In patients who underwent simple coiling (128 patients), PETRA showed a higher sensitivity in the detection of residual flow than TOF and CE (PETRA, 100%; CE, 83%; TOF, 80%). There were no significant differences in the height of residual flow between DSA (0.68 ± 1.45 mm) and PETRA (0.70 ± 1.50 mm; P = 1.000). In patients who underwent stent-assisted coiling (61 patients), PETRA showed the highest sensitivity (88%) in detecting residual flow (CE, 56%; TOF, 31%). Regarding in-stent flow, PETRA, CE, and TOF showed visual scores of ≥3 with frequencies of 96.7%, 85.2%, and 37.7%, respectively. Relative signal-to-noise ratio of PETRA (0.62 ± 0.18) was significantly higher than that of CE (0.56 ± 0.12) and TOF (0.39 ± 0.12; P &lt; .001 for both). CONCLUSION PETRA-MRA showed excellent diagnostic performance in terms of residual flow detection and in-stent flow assessment. PETRA could be a versatile alternative sequence for following up patients with coiled aneurysm.

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