Evaluation of post-procedure changes in aneurysmal lumen following detachable coil-placement using multi-planar reconstruction of high-field (3.0T) magnetic resonance angiography.
BACKGROUND
Placement of detachable coil(s) for intracranial aneurysms has become one of the standard methods of management. Although detailed analysis of post-procedure changes in aneurysmal lumen is essential, technical difficulties often limit such evaluation. Development of higher magnetic field systems is steadily widening clinical usage of magnetic resonance imaging (MRI) primarily due to its significantly higher signal to noise ratio.


OBJECTIVE
In this study, we evaluated a multi-planar reconstruction (MPR) technique of magnetic resonance angiography (MRA) on a 3.0T system in an attempt to develop a routine method of post-procedure evaluation following detachable coil placement.


METHODS
Eleven patients with an intracranial aneurysm following placement of a Guglielmi detachable coil (GDC) participated in the study. Time of flight (TOF) magnetic resonance angiography (MRA) was obtained immediately after, and up to two years after coil embolisation utilising a GE 3.0T system. Data was analysed using standard maximum intensity projection (MIP) as well as the MPR technique and the results were compared to conventional catheter angiography.


RESULTS
The study demonstrated that, compared to MIP, MPR can provide further information of alteration in aneurysm lumen, especially in analysis of: 1) jet of blood flow, 2) thrombus formation, 3) neck remnant or re-filling of blood, 4) location and shape of coils including compaction, and 5) coil protrusion into the parent artery.


CONCLUSIONS
Combined MPR/MIP analysis of high-field MRA appears to be a powerful non-invasive method for evaluating GDC-treatment that can potentially replace conventional catheter angiography in many clinical situations.
Yoneoka
Y
Y
Department of Neurosurgery, Brain Research Institute, University of Niigata, Niigata, Japan.
Watanabe
M
M
Nishino
K
K
Ito
Y
Y
Kwee
I L
IL
Nakada
T
T
Fujii
Y
Y
D000328:Adult; D000368:Aged; D015901:Angiography, Digital Subtraction; D002536:Cerebral Arteries / Q000473:pathology; D004621:Embolization, Therapeutic; D004868:Equipment Failure; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007091:Image Processing, Computer-Assisted; D021621:Imaging, Three-Dimensional; D002532:Intracranial Aneurysm / Q000473:pathology / Q000628:therapy*; D018810:Magnetic Resonance Angiography / Q000295:instrumentation; D008297:Male; D008875:Middle Aged; D012680:Sensitivity and Specificity