Suspected Metallic Embolism following Endovascular Treatment of Intracranial Aneurysms.
We describe a case series of suspected metallic embolism after coil embolization for intracranial aneurysms. Between January 2012 and December 2014, 110 intracranial aneurysms had been treated by coil embolization in our institution. In 6 cases, the postprocedural MR imaging revealed abnormal spotty lesions not detected on the preprocedural MR imaging. The lesions were also undetectable on the postprocedural CT scan. They were demonstrated as low-intensity spots on T1WI, T2WI, DWI, and T2*-weighted imaging. On DWI, they were accompanied by bright "halo," and on T2*-weighted imaging, they showed a "blooming" effect. In 3 of the 6 cases, follow-up MR imaging was available and all the lesions remained and demonstrated no signal changes. Although histologic examination had not been performed, these neuroradiologic findings strongly supported the lesions being from metallic fragments. No specific responsible device was detected after reviewing all the devices used for the neuroendovascular treatment in the 6 cases.
From the Departments of Neurosurgery (R.Y., Y.N., Y.U., N.T., H.Sakaida, H.Suzuki) yasudar1@gmail.com.
R
0000-0002-2144-0297
R
Yasuda
Radiology (M.U., M.M.), Mie University Graduate School of Medicine, Tsu, Mie, Japan.
M
0000-0002-6532-399X
M
Maeda
Radiology (M.U., M.M.), Mie University Graduate School of Medicine, Tsu, Mie, Japan.
M
0000-0002-0732-7212
M
Umino
From the Departments of Neurosurgery (R.Y., Y.N., Y.U., N.T., H.Sakaida, H.Suzuki).
Y
0000-0002-2955-3632
Y
Nakatsuka
From the Departments of Neurosurgery (R.Y., Y.N., Y.U., N.T., H.Sakaida, H.Suzuki).
Y
0000-0002-7039-2949
Y
Umeda
From the Departments of Neurosurgery (R.Y., Y.N., Y.U., N.T., H.Sakaida, H.Suzuki).
N
0000-0001-8174-3428
N
Toma
From the Departments of Neurosurgery (R.Y., Y.N., Y.U., N.T., H.Sakaida, H.Suzuki).
H
0000-0002-7371-4237
H
Sakaida
From the Departments of Neurosurgery (R.Y., Y.N., Y.U., N.T., H.Sakaida, H.Suzuki).
H
0000-0002-8555-5448
H
Suzuki
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D038524:Diffusion Magnetic Resonance Imaging; D004621:Embolization, Therapeutic / Q000009:adverse effects*; D005260:Female; D006801:Humans; D002532:Intracranial Aneurysm / Q000628:therapy*; D020766:Intracranial Embolism / Q000000981:diagnostic imaging / Q000209:etiology*; D008279:Magnetic Resonance Imaging; D008297:Male; D008670:Metals; D008875:Middle Aged; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
D008670:Metals