Three-dimensional Time-of-Flight MR Angiography in the Evaluation of Intracranial Aneurysms Treated with Guglielmi Detachable Coils

Small basilar tip aneurysm found to be incompletely occluded at MR angiography and completely occluded at DSA follow-up after treatment with GDCs.

A, DSA study before treatment shows the presence of a small basilar tip aneurysm.

B, The aneurysm was judged to be completely occluded at the first follow-up DSA study.

C, On the first follow-up 3D-TOF MR angiogram (39/6.2/1), a small residual patency was detected.

D, Residual patency of the aneurysm was confirmed at the second DSA follow-up (6 months after the first follow-up study).

Small basilar trunk aneurysm incompletely occluded after treatment with GDCs, as demonstrated at the first follow-up examination. The patient was retreated, with complete occlusion of the aneurysm noted at 1-year follow-up study.

A, DSA shows the presence of residual patency of the treated aneurysm near the neck.

B, 3D-TOF MR angiogram (43/8/1) shows residual patency with the same extent as seen at DSA, despite the presence of a vascular signal gap, related to the coils, at the P1 segment of the left posterior cerebral artery.

Giant middle cerebral artery bifurcation aneurysm partially treated with incomplete occlusion verified at the 6-month follow-up examination.

A, MIP reconstruction from basal 3D-TOF MR angiogram (43/8/1) shows flow within the portion of the aneurysm seen previously; the slow flow is responsible for low signal of both the aneurysm and the middle cerebral artery branches.

B, Enhanced 3D-TOF MR angiogram (43/8/1) better depicts the partially occluded aneurysm and the patency of the middle cerebral artery branches.