Abstract
Intracranial aneurysm is a focal, abnormal dilation of an artery of the brain. Magnetic resonance angiography (MRA) is a non-invasive technique for vascular imaging and is thus widely used for screening for intracranial vascular lesions. The aim of the study was to show the diagnostic accuracy of 3D Time-of-Flight (3D TOF) MRA in the detection of unruptured cerebral aneurysms with the use of digital subtraction angiography (DSA) as the gold standard. A total of 2.612 consecutive patients underwent 3DTOF MRA. It showed unruptured aneurysms in 94 (3.6%) patients. They included 68 women and 26 men ranging in age from 29 to 76 years (mean, 52.5 years). Twenty-six of them, 20 women and 6 men, underwent DSA. The Mann-Whitney U test was used for the correlation of size. Fisher’s test was used for the correlation of location. The statistical level of significance was set at p 0.05) of aneurysms between TOF MRA and DSA. MRA is an accurate and non-invasive method for diagnosis of unruptured intracranial aneurysms. The results of study show the compatibility of MRA findings, the location and the size of an aneurysm in comparison with the “gold standard” cerebral DSA. Acta Medica Medianae 2015;54(3):12-18.
Highlights
Intracranial aneurysm is a focal, abnormal dilation of an artery of the brain caused by the weakness in the innermost layer of the arterial wall, called the intima
The TOF-Magnetic resonance angiography (MRA) examinations included 94 patients with aneurysms and have shown that an aneurysm is most often located at the bifurcation of the medial cerebral artery (MCA) as detected in 28 of the examined patients (33.33%)
In 26 patients in whom the TOF MRA revealed an aneurysm, digital subtraction angiography (DSA) cerebral angiography was performed and the findings have again shown that the highest incidence of aneurysms occurs at the MCA bifurcation (6/26; 23.07%) (Table 3)
Summary
Intracranial aneurysm is a focal, abnormal dilation of an artery of the brain caused by the weakness in the innermost layer of the arterial wall, called the intima. Aneurysms are most commonly localized in the subarachnoid space at the base of the brain. The four major types of intracranial or cerebral aneurysms include: saccular, fusiform, dissecting, and micotic type. The pressure existing within the arterial blood vessel leads to aneurysm growth i.e. to a gradual appearance of a bulge in the wall of an artery which can gradually become thinner and eventually burst. The result of this rupture is a subarachnoid hemorrhage (SAH), which is clinically manifested by severe headache (”the worst in life") that may or may not be accompanied by nausea, vomiting, stiff neck and neurological changes [2]
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