Contrast-Enhanced and Time-of-Flight MR Angiographic Assessment of Endovascular Coiled Intracranial Aneurysms at 1.5 T.

Abstract

This study evaluated contrast-enhanced magnetic resonance angiography (CE-MRA) and three-dimensional time-of-flight magnetic resonance angiography (3D-TOF-MRA) through comparisons with digital subtraction angiography (DSA) for the follow-up of intracranial aneurysms treated with detachable coils. Sixty-seven patients with 79 aneurysms underwent 3D-TOF-MRA, CE-MRA, and catheter angiography one year after coiling. Two independent observers classified recanalization status on images as neck or body remnant or no recanalization. For 3D-TOF-MRA and CE-MRA, the intermodality agreement, interobserver agreement, and correlation with angiography were assessed. Sixty-seven patients with 79 coiled aneurysms agreed to participate in the study. Three aneurysms could not be detected on 3D-TOF-MRA, so they were excluded from this study. Interobserver agreement was very good for 3D-TOF-MRA and CE-MRA (kappa (κ): 0.87, 0.94, respectively). Correlation of TOF-MRA with angiography was good (κ: 0.76). Correlation of CE-MRA with angiography was excellent (κ: 0.91). The sensitivity and specificity of TOF-MRA were 92% and 98%, respectively. The sensitivity and specificity of CE-MRA were 96% and 98%, respectively. After selective embolization of intracranial aneurysms, CE-MRA is useful and comparable to DSA in the assessment of aneurysmal recanalization. Agreement with the gold standard is stronger with CE-MRA than with 3D-TOF-MRA.