title: Time-of-flight MR angiography at 3T versus digital subtraction angiography in the imaging follow-up of 51 intracranial aneurysms treated with coils.
abstract: OBJECTIVE
  To compare 3D time-of-flight MR angiography (TOF-MRA) at 3 Tesla (3T) with digital subtraction angiography (DSA) for the evaluation of intracranial aneurysm occlusion after endovascular coiling.
  
  
  METHODS
  In a prospective study, 51 consecutive patients (25 females, 26 males; median age, 51 years) with 51 saccular aneurysms treated with endovascular coiling underwent simultaneous DSA and 3T TOF-MRA at follow-up. DSA and TOF-MRA images were analyzed independently by two senior neuroradiologists. Findings were assigned to 1 of 3 categories in the Raymond classification: complete obliteration, residual neck or residual aneurysm. Agreement between observers and techniques was evaluated using kappa statistics.
  
  
  RESULTS
  DSA images were not interpretable for one patient. Interobserver agreement was determined as excellent for DSA (kappa=0.86) and TOF-MRA (kappa=0.80). After reaching a consensus, DSA follow-up showed 26 (51%) complete obliterations, 20 (39%) residual necks and 4 (8%) residual aneurysms. TOF-MRA showed 23 (45%) complete obliterations, 22 (43%) residual necks and 6 (12%) residual aneurysms. Comparison between TOF-MRA and DSA showed excellent agreement between the techniques (kappa=0.86). In the four cases that were misclassified, TOF-MRA findings were assigned to a higher class than for DSA.
  
  
  CONCLUSIONS
  TOF-MRA at 3T is at least as efficient as DSA for the evaluation of intracranial aneurysm occlusion after endovascular treatment with detachable coils. We suggest that TOF-MRA at 3T might be used as the primary method for imaging follow-up of coiled intracranial aneurysms.
authors.affiliation: Department of Neuroradiology, Hôpital Pontchaillou, University Hospital Rennes, Rennes, France. jean-christophe.ferre@chu-rennes.fr
authors.forename: Jean-Christophe
authors.initials: JC
authors.lastname: Ferré
authors.forename: Béatrice
authors.initials: B
authors.lastname: Carsin-Nicol
authors.forename: Xavier
authors.initials: X
authors.lastname: Morandi
authors.forename: Michel
authors.initials: M
authors.lastname: Carsin
authors.forename: Axel
authors.initials: A
authors.lastname: de Kersaint-Gilly
authors.forename: Jean-Yves
authors.initials: JY
authors.lastname: Gauvrit
authors.forename: Hubert-Armand
authors.initials: HA
authors.lastname: Desal
mesh_terms: D000328:Adult; D000368:Aged; D015901:Angiography, Digital Subtraction / Q000379:methods*; D004621:Embolization, Therapeutic / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D002532:Intracranial Aneurysm / Q000175:diagnosis* / Q000628:therapy*; D018810:Magnetic Resonance Angiography / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D016896:Treatment Outcome; D055815:Young Adult