Flow diverters (FD) are innovative treatments for wide-neck intracranial aneurysms. After-treatment verification of embolization and parent vessel patency is crucial. While evaluation using time-of-flight magnetic resonance angiography (TOF-MRA) is useful, it suffers from signal loss within the FD due to susceptibility effects. This study evaluates the usefulness of ultrashort echo time MRA (UTE-MRA) for after-FD assessment compared to TOF-MRA. Vascular phantom experiments were conducted using FDs (FRED®, Pipeline®, Surpass Streamline®). TOF-MRA and UTE-MRA were performed under steady (10, 30, 50 cm/s) and pulsatile (17-61 cm/s, mean 34 cm/s) flow conditions using a 3 T MRI system. As evaluation metrics, relative in-FD signal (RIS) was calculated by comparing the signal intensity inside the FD to that without the FD to assess signal retention, and FD luminal to background signal ratio (FD-LBR) was calculated by comparing the signal intensity inside the FD to that of the surrounding background to evaluate vessel visibility. UTE-MRA showed higher FD-LBR values than TOF-MRA for all FDs (p < 0.01). For RIS, UTE-MRA was significantly higher for FRED® (p < 0.01), but different for other FDs except at 50 cm/s. FRED® exhibited the highest RIS and FD-LBR values under all conditions, followed by Pipeline® and Surpass Streamline®. Flow velocity changes resulted in minimal variations in RIS and FD-LBR values. UTE-MRA provides superior image quality for after-FD assessment, particularly in terms of FD-LBR, compared to TOF-MRA. Differences in FD materials and structures affect image quality. These findings suggest UTE-MRA's clinical utility in follow-up after-FD assessment.
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