title: The clinical value of MRA at 3.0 T for the diagnosis and therapeutic planning of patients with subarachnoid haemorrhage.
abstract: OBJECTIVE
  To evaluate the clinical value of unenhanced magnetic resonance angiography (MRA) at 3.0 T for the diagnosis and therapeutic planning of patients with subarachnoid haemorrhage (SAH).
  
  
  METHODS
  A total of 165 patients with SAH were referred for three-dimensional time-of-flight MRA (3D-TOF-MRA) before digital subtraction angiography (DSA). For each aneurysm, 3D-TOF-MRA was used to determine whether the aneurysm was suitable for coil placement with or without balloon/stent-assisted coiling, surgical clipping or conservative treatment. Treatment planning with 3D-TOF-MRA was compared with actual treatment decisions or treatment that had been carried out in each aneurysm decided using DSA.
  
  
  RESULTS
  The aneurysm-based evaluation yielded accuracy of 96.9%, sensitivity of 97.6%, specificity of 93.1%, positive predictive value (PPV) of 98.8% and negative predictive value (NPV) of 87.1%, in the detection of intracranial aneurysms. Treatment planning could be correctly made on the basis of aneurysm anatomy and working view by volume rendering (VR) 3D-TOF-MRA with accuracy, sensitivity, specificity, PPV and NPV of 94.9%, 94.0%, 100%, 100% and 74.4%, respectively, on a per aneurysm-based evaluation.
  
  
  CONCLUSIONS
  VR 3D-TOF-MRA offers high diagnostic accuracy in the detection of ruptured intracranial aneurysms, and appears to be an effective treatment planning tool for most patients with SAH.
  
  
  CONCLUSIONS
  VR 3D-TOF-MRA offers high diagnostic accuracy for detecting ruptured intracranial aneurysms. • VR 3D-TOF-MRA helps treatment planning for patients with subarachnoid haemorrhage. • 3D-TOF-MRA is non-invasive and avoids using ionising radiation or contrast agents.
authors.affiliation: Institute of Diagnostic and Interventional Radiology, The Sixth Affiliated People's Hospital, Shanghai Jiao Tong University, No. 600, Yi Shan Road, Shanghai, 200233, China.
authors.forename: Yuan-Chang
authors.initials: YC
authors.lastname: Chen
authors.forename: Zhen-Kui
authors.initials: ZK
authors.lastname: Sun
authors.forename: Ming-Hua
authors.initials: MH
authors.lastname: Li
authors.forename: Yong-Dong
authors.initials: YD
authors.lastname: Li
authors.forename: Wu
authors.initials: W
authors.lastname: Wang
authors.forename: Hua-Qiao
authors.initials: HQ
authors.lastname: Tan
authors.forename: Bin-Xian
authors.initials: BX
authors.lastname: Gu
authors.forename: Shi-Wen
authors.initials: SW
authors.lastname: Chen
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017542:Aneurysm, Ruptured / Q000473:pathology* / Q000628:therapy*; D003657:Decision Making; D005260:Female; D006801:Humans; D018810:Magnetic Resonance Angiography / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013345:Subarachnoid Hemorrhage / Q000473:pathology* / Q000628:therapy*; D055815:Young Adult