Monitoring Serial Change in the Lumen and Outer Wall of Vertebrobasilar Aneurysms

Boussel, Loîc; Wintermark, Max; Martin, Alastair J.; Dispensa, Bradley P.; VanTijen, R.; Leach, Joseph; Rayz, Vitaliy L.; Acevedo-Bolton, Gabriel; Lawton, Michael T.; Higashida, Randall T.; Smith, Wade S.; Young, William L.; Saloner, David

doi:10.3174/ajnr.a0796

Cited by 10 publications

(8 citation statements)

References 18 publications

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“…Thrombus deposition and aneurysm morphometry, however, are inherently 3D, and a comprehensive evaluation of aneurysm geometric properties and how they evolve with time requires more sophisticated analysis. 28 While this may not be possible at many centers, it is clearly important to include the thrombosed component in any measures that are made. This represents an additional advantage of steady-state techniques, which are fast and readily adapted to 3D volumetric coverage.…”

Section: Discussionmentioning

confidence: 99%

MR Imaging of Partially Thrombosed Cerebral Aneurysms: Characteristics and Evolution

Martin

Hetts²,

Dillon³

et al. 2010

AJNR Am J Neuroradiol

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BACKGROUND AND PURPOSE A comprehensive evaluation of aneurysmal morphometry requires appreciation of both the vascular lumen and the intraluminal thrombus. MR imaging methods can both evaluate the lumen and directly image the vessel wall. We investigated the ability of T1-weighted, T2-weighted, and steady-state MR imaging techniques to delineate thrombus morphology and reveal changes with time. MATERIALS AND METHODS Nine patients with fusiform basilar or intracranial vertebral artery aneurysms that contained intraluminal thrombus were studied with MR imaging. All patients underwent at least 2 imaging sessions, which were separated by 4–22 months. Analysis of signal intensity to determine the mean signal intensity from thrombus, blood, CSF, and brain in matched regions was performed. Aneurysm maximal diameter and cross-sectional area were determined with and without thrombus. RESULTS Thrombus was identified on all image sequences, and its general appearance was consistent between imaging sessions. Thrombus produced the highest and most consistent signal intensities with T1-weighted and steady-state techniques, though the latter showed superior contrast between luminal blood and thrombus. Heterogeneity within clot was evident in 4/9 of patients, with peripheral hyperintensity being a common feature. CONCLUSIONS Steady-state imaging was found to be superior to T1- and T2-weighted imaging for delineating and characterizing intraluminal thrombus within aneurysms. The imaging characteristics of intraluminal thrombus proved to be very consistent for long periods. Assessment of overall aneurysm size, including thrombosed portions, permits more accurate evaluation of aneurysm growth and concomitantly may permit more informed clinical decision-making with regard to the timing and need for aneurysm treatment.

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Section: Discussionmentioning

confidence: 99%

MR Imaging of Partially Thrombosed Cerebral Aneurysms: Characteristics and Evolution

Martin

Hetts²,

Dillon³

et al. 2010

AJNR Am J Neuroradiol

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“…The analysis of the aneurysm lumen pursued here was similar to that reported previously(9). In brief, CE-MRA images were directly imported into a commercially available 3D data processing software package RapidForm® (INUS Technology, Seoul, South Korea) which allows creation of isosurfaces directly from a DICOM data set after the user chooses an intensity threshold.…”

Section: Methodsmentioning

confidence: 58%

“…In all cases, it is also impossible to assure that three linear measurements accurately reflect the global changes in lumen shape and size that might have taken place over time. We have previously reported on a quantitative method for measuring morphology change by determining lumenal volume changes from co-registered 3D volume sets acquired at different time points (8, 9). That method obviates the need for specifying optimal view planes or for achieving equivalent view angles at different time points.…”

Section: Introductionmentioning

confidence: 99%

Temporal Stability of Dysmorphic Fusiform Aneurysms of the Intracranial Internal Carotid Artery

Boussel

Rayz

Martin

et al. 2011

Journal of Vascular and Interventional Radiology

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Purpose Estimation of the stability of dysmorphic fusiform aneurysms of the intra-cranial internal carotid artery requires precise monitoring of their volumes. In this report we apply a method using MRI and 3D post-processing to study the evolution of these aneurysms on a prospective cohort of patients not immediately suitable for surgery or endovascular treatment. Materials and Methods Ten patients with fusiform aneurysms of the intra-cranial internal carotid artery underwent serial MRI studies. Five patients were studied at two time points and the remainder at multiple time points (mean delay between studies: 12.6 +/− 3.8 months). For each patient, studies from all time points were co-registered. Volumes of each vessel component were calculated. Results Mean aneurysm volume was 833 +/− 878 mm3. Mean annual rate of volume progression was 1.37 +/− 2.09 % per year. All the aneurysms were thrombus-free. Conclusion This study indicates that, given the relatively low rate of progression of these dysplastic fusiform aneurysms and the complexity of their shape, 3D quantitative volumetric methods can be helpful in monitoring whether any growth has occurred.

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“…In previously published in vivo aneurysm wall imaging studies, depiction of microstructures within aneurysm walls was limited by spatial resolution, [13][14][15] because wall thicknesses ranged from 20 to 500 m. 16,17 To date, there is only 1 report on intracranial vessel wall microstructures delineated with 7T MR imaging using an ultra-high ex vivo 0.11 ϫ 0.11 mm 2 resolution. 18 The study showed excellent correlation with the histopathologic findings.…”

Section: Discussionmentioning

confidence: 99%

Giant Intracranial Aneurysms at 7T MRI

Matsushige

Chen

Ringelstein

et al. 2015

AJNR Am J Neuroradiol

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SUMMARY: Giant intracranial aneurysms are rare vascular pathologies associated with high morbidity and mortality. The purpose of this in vivo study was to assess giant intracranial aneurysms and their wall microstructure by 7T MR imaging, previously only visualized in histopathologic examinations. Seven giant intracranial aneurysms were evaluated, and 2 aneurysms were available for histopathologic examination. Six of 7 (85.7%) showed intraluminal thrombus of various sizes. Aneurysm walls were depicted as hypointense in TOF-MRA and SWI sequences with excellent contrast ratios to adjacent brain parenchyma (range, 0.01-0.60 and 0.58 -0.96, respectively). The triple-layered microstructure of the aneurysm walls was visualized in all aneurysms in TOF-MRA and SWI. This could be related to iron deposition in the wall, similar to the findings in 2 available histopathologic specimens. In vivo 7T TOF-MRA and SWI can delineate the aneurysm wall and the triple-layered wall microstructure in giant intracranial aneurysms. ABBREVIATIONS:GA ϭ giant intracranial aneurysm; SEM ϭ standard error of the mean

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Monitoring Serial Change in the Lumen and Outer Wall of Vertebrobasilar Aneurysms

Abstract: BACKGROUND AND PURPOSE:Estimation of the stability of fusiform aneurysms of the basilar artery requires precise monitoring of the luminal and outer wall volumes. In this report we describe the use of MR imaging and 3D postprocessing methods to study the evolution of those aneurysms.

Cited by 10 publications

References 18 publications

MR Imaging of Partially Thrombosed Cerebral Aneurysms: Characteristics and Evolution

MR Imaging of Partially Thrombosed Cerebral Aneurysms: Characteristics and Evolution

Temporal Stability of Dysmorphic Fusiform Aneurysms of the Intracranial Internal Carotid Artery

Giant Intracranial Aneurysms at 7T MRI

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