title: Time-resolved imaging of contrast kinetics does not improve performance of follow-up MRA of embolized intracranial aneurysms.
abstract: BACKGROUND
  The use of contrast media and the time-resolved imaging of contrast kinetics (TRICKS) technique have some theoretical advantages over time-of-flight magnetic resonance angiography (TOF-MRA) in the follow-up of intracranial aneurysms after endovascular treatment. We prospectively compared the diagnostic performance of TRICKS and TOF-MRA with digital subtracted angiography (DSA) in the assessment of occlusion of embolized aneurysms.
  
  
  METHODS
  Seventy-two consecutive patients with 72 aneurysms were examined 3 months after embolization. Test characteristics of TOF-MRA and TRICKS were calculated for the detection of residual flow. The results of quantification of flow were compared with weighted kappa. Intraobserver and interobserver reproducibility was determined.
  
  
  RESULTS
  The sensitivity of TOF-MRA was 85% (95% CI, 65-96%) and of TRICKS, 89% (95% CI, 70-97%). The specificity of both methods was 91% (95% CI, 79-98%). The accuracy of the flow quantification ranged from 0.76 (TOF-MRA) to 0.83 (TRICKS). There was no significant difference between the methods in the area under the ROC curve regarding both the detection and the quantification of flow. Intraobserver reproducibility was very good with both techniques (kappa, 0.86-0.89). The interobserver reproducibility was moderate for TOF-MRA and very good for TRICKS (kappa, 0.74-0.80).
  
  
  CONCLUSIONS
  In this study, TOF-MRA and TRICKS presented similar diagnostic performance; therefore, the use of time-resolved contrast-enhanced MRA is not justified in the follow-up of embolized aneurysms.
authors: Department of Radiology and Diagnostic Imaging, Nicolaus Copernicus University, Collegium Medicum, Bydgoszcz, Poland. serafin@cm.umk.pl
authors: Zbigniew
authors: Z
authors: Serafin
authors: Piotr
authors: P
authors: Strześniewski
authors: Władysław
authors: W
authors: Lasek
authors: Wojciech
authors: W
authors: Beuth
mesh_terms: D002343:Carotid Artery, Internal / Q000000981:diagnostic imaging; D003287:Contrast Media; D004621:Embolization, Therapeutic; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D021621:Imaging, Three-Dimensional / Q000379:methods*; D002532:Intracranial Aneurysm / Q000000981:diagnostic imaging* / Q000628:therapy*; D007700:Kinetics; D018810:Magnetic Resonance Angiography / Q000379:methods* / Q000592:standards*; D008297:Male; D008875:Middle Aged; D011859:Radiography; D013997:Time Factors
chemical_list: D003287:Contrast Media