Intracranial Aneurysms: Detection with Gadolinium-enhanced Dynamic Three-dimensional MR Angiography—Initial Results

Metens, Thierry; Rio, Fatima; Balériaux, Danielle; Roger, Thierry; David, Philippe; Rodesch, Georges

doi:10.1148/radiology.216.1.r00jl1139

Cited by 82 publications

(33 citation statements)

References 16 publications

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“…Similarly, we infer a voxel volume of 1.39 mm 3 (before zero-filling) from the technical parameters of the 1.5T intracranial aneurysm work described by Metens et al (6). By this measure, 3.0T is halving the voxel volume, as expected.…”

Section: Discussionmentioning

confidence: 67%

High‐resolution intracranial and cervical MRA at 3.0T: Technical considerations and initial experience

Huston¹,

Chen²,

Gibbs³

et al. 2001

Magn. Reson. Med.

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Initial experience with intracranial and cervical MRA at 3.0T is reported. Phantom measurements (corrected for relaxation effects) show S/N (3.0T) ‫؍‬ 2.14 ؎ 0.08 ؋ S/N (1.5T) in identical-geometry head coils. A 3.0T 3DTOF intracranial imaging protocol with higher-order autoshimming was developed and compared to 1.5T 3DTOF in 12 patients with aneurysms. A comparison by two radiologists showed the 3.0T to be significantly better (P < 0.001) for visualization of the aneurysms. The feasibility of cervical and intracranial contrast enhanced MR angiography (CEMRA) at 3.0T is also examined. The relaxivity of the gadolinium contrast agent decreases by only about 4 -7% when the field strength is increased from 1.5 to 3.0T. Cervical 3.0T CEMRA was obtained in eight patients, two of whom had 1.5T studies available for direct comparison. Image comparison suggests 3.0T to be a favorable field strength for cervical CEMRA. Voxel volumes of 0.62-0.73 mm 3 (not including zero-filling) were readily achieved at 3.0T with the use of a single-channel transmitreceive head or cervical coil, a 25 mL bolus of gadoteridol, and a 3D pulse sequence with a 66% sampling efficiency. This spatial resolution allowed visualization of intracranial aneurysms, carotid dissections, and atherosclerotic disease including ulcerations. Potential drawbacks of 3.0T MRA are increased SAR and T* 2 dephasing compared to 1.5T. Image comparison suggests signal loss due to T* 2 dephasing will not be substantially more problematic than at 1.5T. The 1998 revision of the U.S. Food and Drug Administration guidelines (1) states that MRI systems with main static field strengths of 4.0T and less can qualify as nonsignificant risk devices. Moreover, with the advent of actively shielded magnet technology it is now feasible to site a 3.0T scanner in a clinical setting. Much of the prior use of 3.0T and higher field strength MRI systems, however, has been for pure or clinical research, mostly in the fields of functional brain MRI (e.g., 2,3) and spectroscopy (e.g., 4). This is quite logical, since fMRI and spectroscopy benefit not only from the increased S/N of 3.0T, but also from the linear dependence of magnetic susceptibility changes and chemical shift, respectively.We have applied our 3.0T system to both clinical research and routine clinical use. During the period October 1999 to May 2001, 2908 routine clinical brain exams were performed in an outpatient setting (5). The purpose of this article is twofold: 1) to provide an initial comparison of intracranial 3D time of flight (3DTOF) magnetic resonance angiography (MRA) at 1.5 and 3.0T; and 2) to establish the initial feasibility of 3D contrast-enhanced MR angiography (CEMRA) for the cervical and intracranial arteries at 3.0T. CEMRA is already a well-established technique at 1.5T and has been applied previously to study both intracranial aneurysms (6) and the cervical arteries (7). We examined whether the increased S/N available at 3.0T can translate into increased spatial resolution for CEMRA. We believe that the de...

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Section: Discussionmentioning

confidence: 67%

High‐resolution intracranial and cervical MRA at 3.0T: Technical considerations and initial experience

Huston¹,

Chen²,

Gibbs³

et al. 2001

Magn. Reson. Med.

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“…19 In the latter study, only 1 aneurysm was not detected by 3D-TOF MRA, which was of poor quality because of patient movement artifact. Furthermore, differences in diagnostic confidence in the presence of an aneurysm were not significant between contrast-enhanced MRA and 3D-TOF MRA.…”

Section: Okahara Et Almentioning

confidence: 82%

Diagnostic Accuracy of Magnetic Resonance Angiography for Cerebral Aneurysms in Correlation With 3D–Digital Subtraction Angiographic Images

Okahara

Kiyosue

Yamashita

et al. 2002

Stroke

142

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Background and Purpose-We investigated the sensitivity of 3D-time-of flight (3D-TOF) magnetic resonance angiography (MRA) in the detection of cerebral aneurysms with the use of 3D digital subtraction angiography as the gold standard. We also evaluated the effects of location and number of aneurysms (and experience of the reader) on the sensitivity. Methods-3D-TOF MRA was performed in 82 patients with 133 cerebral aneurysms. Each patient underwent rotational angiography. Three-dimensional reconstructed images were obtained from data of the rotational angiography (as the gold standard). A blind study with 4 readers of different experiences was performed to evaluate the diagnostic accuracy of 3D-TOF MRA for cerebral aneurysms. Results-One hundred five (79%) of all 133 aneurysms were detected with MRA by a neuroradiologist, 100 (75%) were detected by an experienced neurosurgeon, 84 (63%) were detected by a general radiologist, and 80 (60%) were detected by a resident neuroradiologist. For each reader, the detectability was lower for small aneurysms (Ͻ3 mm in maximum diameter) and/or for those located at the internal carotid artery and anterior cerebral artery. False-positive aneurysms were 29 for the neuroradiologist, 19 for the neurosurgeon, 31 for the general radiologist, and 30 for the resident neuroradiologist; most of the aneurysms were at the internal carotid artery. Causes of the false-positive and false-negative results included complex flow in a tortuous artery and susceptibility artifacts. Conclusions-Although MRA is useful in the diagnosis of cerebral aneurysms, sufficient experience and careful attention are necessary for accurate diagnosis of aneurysms located at the internal carotid and anterior cerebral arteries. (Stroke.

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“…MR angiography with contrast medium is better than 3D-TOF MR angiography for the detection of aneurysms with slow flow because less signal reduction occurs due to turbulence or flow saturation effect. 10) Although we failed to detect the aneurysm in our case by repeated 3D-TOF MR angiography, MR angiography with contrast medium possibly could have done so.…”

Section: Discussionmentioning

confidence: 58%

Intracerebral Hemorrhage From a Ruptured Aneurysm at the Site of Anastomosis 27 Years After Superficial Temporal Artery-Middle Cerebral Artery Bypass -Case Report-

Hokari

Yasuda

Iwasaki

et al. 2010

Neurol. Med. Chir.(Tokyo)

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A 77-year-old female presented with a very rare case of intracerebral hemorrhage (ICH) from a ruptured aneurysm at the site of the anastomosis 27 years after superficial temporal artery-middle cerebral artery (STA-MCA) bypass manifesting as sudden onset of unconsciousness and right hemiparesis. Computed tomography (CT) on admission demonstrated massive ICH in the left frontoparietal region. Magnetic resonance angiography showed good patency of the anastomosis and no obvious aneurysm, but threedimensional CT (3D-CT) angiography revealed a small aneurysm at the site of the left STA-MCA anastomosis. Emergency evacuation of the hematoma was performed, and the aneurysm was trapped and resected after ligation. After the operation, she continued to exhibit deep consciousness disturbance. Unfortunately, her general condition grew steadily worse and she died 3 months later. Patients who undergo STA-MCA anastomosis should be carefully followed up by periodical imaging examinations. 3D-CT angiography is very useful to detect aneurysm formation at the anastomosis site.

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Intracranial Aneurysms: Detection with Gadolinium-enhanced Dynamic Three-dimensional MR Angiography—Initial Results

Abstract: Dynamic 3D contrast-enhanced T1-weighted MR angiography is a fast, efficient, and minimally invasive imaging method with which to diagnose intracranial aneurysms.

Cited by 82 publications

References 16 publications

High‐resolution intracranial and cervical MRA at 3.0T: Technical considerations and initial experience

High‐resolution intracranial and cervical MRA at 3.0T: Technical considerations and initial experience

Diagnostic Accuracy of Magnetic Resonance Angiography for Cerebral Aneurysms in Correlation With 3D–Digital Subtraction Angiographic Images

Intracerebral Hemorrhage From a Ruptured Aneurysm at the Site of Anastomosis 27 Years After Superficial Temporal Artery-Middle Cerebral Artery Bypass -Case Report-

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