Magnetic Resonance Imaging Follow-Up of Large or Giant Vertebrobasilar Dissecting Aneurysms After Total Embolization on Angiography.
OBJECTIVE
To evaluate the outcomes of large or giant vertebrobasilar dissecting aneurysms (VBDAs) after endovascular total embolization by follow-up 3T magnetic resonance imaging (MRI).


METHODS
Between November 2011 and July 2015, 4 patients had unruptured large or giant VBDAs that were treated with endovascular techniques with total embolization of VBDAs confirmed on follow-up angiography, but the patients had persistent or worsened symptoms. Preoperative and postoperative 3T high-resolution MRI was performed to evaluate arterial wall evolution.


RESULTS
Follow-up angiographic results were satisfactory in all 4 patients; however, symptoms in cases 1, 2, and 4 worsened, and symptoms in case 3 did not improve. Postoperative high-resolution MRI in case 1 showed a new intramural hematoma, and postoperative high-resolution MRI of cases 2, 3, and 4 showed persistent intramural hemorrhagic signals. Follow-up MRI showed increased aneurysm size in cases 1, 2, and 4 but no size change in case 3.


CONCLUSIONS
The efficacy of conventional endovascular treatment (e.g., internal trapping with coils, stent-assisted coiling, and stent placement without coils) for large or giant VBDAs is uncertain. Follow-up angiography alone does not adequately predict the outcome. High-resolution MRI is a worthwhile adjunct to follow these lesions.
Department of Interventional Neuroradiology, Beijing Neurosurgical Institute, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
Yisen
Y
Zhang
Department of Neurosurgery, First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan Province, China.
Yanmin
Y
Wang
Department of Neuroradiology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
Binbin
B
Sui
Department of Interventional Neuroradiology, Beijing Neurosurgical Institute, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
Youxiang
Y
Li
Department of Interventional Neuroradiology, Beijing Neurosurgical Institute, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
Shiqing
S
Mu
Department of Interventional Neuroradiology, Beijing Neurosurgical Institute, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
Ying
Y
Zhang
Department of Interventional Neuroradiology, Beijing Neurosurgical Institute, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
Zhongxue
Z
Wu
Department of Interventional Neuroradiology, Beijing Neurosurgical Institute, Beijing Tiantan Hospital, Capital Medical University, Beijing, China. Electronic address: yang-xj@163.net.
Xinjian
X
Yang
D000784:Aortic Dissection / Q000000981:diagnostic imaging* / Q000628:therapy*; D001488:Basilar Artery / Q000000981:diagnostic imaging; D002533:Cerebral Angiography; D004621:Embolization, Therapeutic / Q000379:methods*; D005500:Follow-Up Studies; D006801:Humans; D002532:Intracranial Aneurysm / Q000000981:diagnostic imaging* / Q000628:therapy*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D014711:Vertebral Artery / Q000000981:diagnostic imaging
Dissection; Endovascular techniques; Intracranial aneurysms; Magnetic resonance imaging