Diagnosing Intracranial Aneurysms With MR Angiography

Abstract

Background and Purpose-The aim of this study was to evaluate the sensitivity and specificity of MR angiography (MRA) in the diagnosis of ruptured and unruptured intracranial aneurysms. Methods-A systematic search was performed on 4 electronic databases on relevant articles that were published from January 1998 to October 2013. Inclusion criteria were met by 12 studies that compared MRA with digital subtraction angiography as reference standard. Two independent reviewers evaluated the methodological quality of the studies. Data from eligible studies were extracted and used to construct 2×2 contingency tables on a per-aneurysm level. Pooled estimates of sensitivity and specificity were calculated for all studies and subgroups of studies. Heterogeneity was tested, and risk for publication bias was assessed. Results-Included studies were of high methodological quality. Studies with larger sample size tended to have higher diagnostic performance. Most studies used time-of-flight MRA technique. Among the 960 patients assessed, 772 aneurysms were present. Heterogeneity with reference to sensitivity and specificity was moderate to high. Pooled sensitivity of MRA was 95% (95% confidence interval, 89%-98%), and pooled specificity was 89% (95% confidence interval, 80%-95%). False-negative and false-positive aneurysms detected on MRA were mainly located at the skull base and middle cerebral artery. Freehand 3-dimensional reconstructions performed by the radiologist significantly increased diagnostic performance. Studies performed on 3 Tesla showed a trend toward higher performance (P=0.054). Conclusions-Studies

Imaging of cerebral aneurysms: a clinical perspective

“…4). A meta-analysis of MRA studies for evaluating aneurysms demonstrated that contrast-enhanced MRA (CE-MRA) and TOF had similar sensitivity for the detection of aneurysms [27]. CE-MRA, however, was found to be superior to TOF sequences because of its ability to eliminate flow-related artifacts and spin saturation [28].…”

“…With current sequences, the spatial resolution at 1.5 T is often as low as 1 mm [31], whereas at 3 T the spatial resolution can be as low as 0.6-0.7 mm while preserving the signal-to-noise ratio [32]. Radiologists also unanimously report significantly better visualization of aneurysms at 3 T. A meta-analysis by Sailer et al [27] that evaluated the sensitivity of MRA for detection of cerebral aneurysms found a trend towards significance in better detection of smaller aneurysms on 3 T versus 1.5 T scanners (p = 0.054). This study reported a pooled sensitivity of 1.5 T and 3 T scanners of approximately 95 % for all aneurysms.…”

Detection rate of aneurysms and subarachnoid hemorrhage in patients who underwent cranial CT angiography due to severe headache

“…Ancak işlemin uzun sürmesi ve artefaktlardan yoğun olarak etkilenmesi tetkikin kullanımını kısıtlamaktadır. Literatürde MRA'nın DSA ile karşılaştırmasında, anevrizma saptamada yüksek değerlik ve doğrulukta olduğunu vurgulayan çalışmalar mevcuttur (6)(7)(8) . BTA'nın DSA'ya göre ucuz, kolay ulaşılabilir, hızlı ve güvenli olması, acil şartlarda kolaylıkla uygulanabilmesi ve özellikle de non-invaziv olması nedeniyle, DSA yerine kullanımı kabul gören ve yaygın kullanılan bir teknik hâline gelmiştir.…”

Management of Intracranial Incidental Findings on Brain MRI

“…Aneurysms can be easily identified if the examination protocol includes MR angiography. Due to its local resolution, TOF angiography also has high sensitivity for even small aneurysms [38]. However, they can also be distinguished in contrast-enhanced T1w images (• ▶ Fig.…”