Abstract
Intracranial aneurysms constitute a common pathological entity, affecting approximately 1–8% of the general population. Their early detection is essential for their prompt treatment. Digital subtraction angiography is considered the imaging method of choice. However, other noninvasive methodologies such as CTA and MRA have been employed in the investigation of patients with suspected aneurysms. MRA is a noninvasive angiographic modality requiring no radiation exposure. However, its sensitivity and diagnostic accuracy were initially inadequate. Several MRA techniques have been developed for overcoming all these drawbacks and for improving its sensitivity. 3D TOF MRA and contrast-enhanced MRA are the most commonly employed techniques. The introduction of 3 T magnetic field further increased MRA's sensitivity, allowing detection of aneurysms smaller than 3 mm. The development of newer MRA techniques may provide valuable information regarding the flow characteristics of an aneurysm. Meticulous knowledge of MRA's limitations and pitfalls is of paramount importance for avoiding any erroneous interpretation of its findings.
Highlights
It is well known that intracranial aneurysms are identified in 1–8% of the general population [1]
We examine the role of 3 T magnetic resonance angiography (MRA) in the detection and treatment decision algorithm of intracranial aneurysms
It needs to be mentioned that even though Digital subtraction angiography (DSA) is still considered the gold standard for imaging intracranial aneurysms, in patients presenting with subarachnoid hemorrhage (SAH), Computed tomographic angiography (CTA) is generally accepted as the initial method of evaluation
Summary
It is well known that intracranial aneurysms are identified in 1–8% of the general population [1]. Magnetic resonance angiography (MRA) are routinely utilized nowadays in clinical practice These noninvasive imaging methods have undergone significant advances in image quality becoming more and more sensitive and accurate. Patients presenting with subarachnoid hemorrhage (SAH) are initially investigated with CTA This modality is readily available and provides quite accurate information regarding the cause of SAH in a timely fashion. Specific patient populations present an increased risk for intracranial aneurysms These are patients with polycystic kidney disease, Marfan syndrome, coarctation of the aorta, fibromuscular dysplasia, family history of saccular aneurysm, and Ehlers-Danlos syndrome. In such patients, a minimally invasive, sensitive, and highly accurate method needs to be available for their investigation. We present a brief historical overview of MRA, the currently used techniques, their pitfalls, and the MRA’s clinical significance by systematically reviewing the pertinent literature
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