title: MR-DWI-positive lesions and symptomatic ischemic complications after coiling of unruptured intracranial aneurysms.
abstract: OBJECTIVE
  The aims of this study are to evaluate the risk factors for symptomatic ischemic complication (symptomatic ischemic complication [SIC], transient ischemic attack, or stroke) and microembolisms detected as MR diffusion-weighted imaging (MR-DWI)-positive (DWI(+)) lesions, and the relationship between DWI(+) and SIC after coiling of unruptured intracranial aneurysm.
  
  
  METHODS
  Between March 2009 and November 2011, 382 unruptured intracranial aneurysms in 343 patients underwent both coiling and posttreatment MR-DWI. The incidence of and risk factors for SIC and DWI(+), and the relationship between DWI(+) and SIC were retrospectively analyzed.
  
  
  RESULTS
  The incidence of SIC was 4.1%. The incidence of DWI(+) was 54.5%. The number of DWI(+) lesions was significantly larger in the SIC group, than in the asymptomatic one (12.1±10.4 versus 5.0±8.7, P<0.00). The cutoff value of DWI(+) for predicting SIC was ≥6 (sensitivity 85.7%, specificity 70.7%). The patients with DWI(+) ≥6 was 28.6%. Of the patients with SIC, the patients with DWI(+) ≥6 was 78.6%. Patients aged≥65 years had a trend for SIC, and it was the only independent risk factor for DWI(+) ≥cutoff (n=6; 95%CI, 1.167-3.083).
  
  
  CONCLUSIONS
  The number of DWI(+) lesions was significantly larger in the SIC group than in the asymptomatic one after coiling of unruptured intracranial aneurysm. Patients aged≥65 had a trend for SIC, and it was the only independent risk factor for the number of DWI(+) ≥cutoff value (n=6) for predicting SIC.
authors.affiliation: Department of Radiology, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Dong-Hun
authors.initials: DH
authors.lastname: Kang
authors.forename: Byung Moon
authors.initials: BM
authors.lastname: Kim
authors.forename: Dong Joon
authors.initials: DJ
authors.lastname: Kim
authors.forename: Sang Hyun
authors.initials: SH
authors.lastname: Suh
authors.forename: Dong Ik
authors.initials: DI
authors.lastname: Kim
authors.forename: Yong-Sun
authors.initials: YS
authors.lastname: Kim
authors.forename: Seung Kon
authors.initials: SK
authors.lastname: Huh
authors.forename: Jaechan
authors.initials: J
authors.lastname: Park
authors.forename: Jae Whan
authors.initials: JW
authors.lastname: Lee
authors.forename: Yong Bae
authors.initials: YB
authors.lastname: Kim
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D038524:Diffusion Magnetic Resonance Imaging; D004621:Embolization, Therapeutic / Q000009:adverse effects* / Q000295:instrumentation / Q000379:methods; D005260:Female; D006801:Humans; D015994:Incidence; D002532:Intracranial Aneurysm / Q000628:therapy*; D002546:Ischemic Attack, Transient / Q000453:epidemiology* / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D012680:Sensitivity and Specificity; D020521:Stroke / Q000453:epidemiology* / Q000473:pathology*