Article Figures & Data
Figures
- FIG 1.
Follow-up images of a left vertebral artery dissecting aneurysm treated by LVIS stent-assisted coiling 6 months after the procedure. White arrows indicate the location of the aneurysm. A, DSA shows that the aneurysm involves incomplete occlusion and the stented artery is normal. B and C, MPR and MIP images of TOF-MRA show an aneurysm remnant. Moderate artifacts and a stenosis are observed at the stented artery on TOF-MRA. D and E, On pre- and postcontrast 3D T1-weighted SPACE, though no aneurysm remnant is observed, the stented artery is depicted well and indicates an absence of stenosis. The postcontrast image shows enhancement of the aneurysm wall, aneurysm lumen, and stented artery. The image quality score assigned by the 2 reviewers for TOF-MRA and 3D T1WI SPACE is 3/3 and 5/5, respectively.
- FIG 2.
Follow-up images of a left vertebral artery dissecting aneurysm treated with LVIS stent-assisted coiling at the third month postoperatively. A, DSA shows recurrence of the aneurysm and mild stenosis of the proximal stented artery. Arrowheads indicate the stent edges. B and C, MPR and MIP images of TOF-MRA show the residual aneurysm lumen (white arrow) clearly. However, substantial artifacts and severe stenosis are observed at the proximal stented artery on TOF-MRA. D and E, On pre- and postcontrast 3D T1-weighted SPACE, the residual aneurysm lumen (white arrow) is depicted clearly, and an intramural hematoma (outline arrow) is observed. The depiction of the in-stent lumen is similar to that of DSA, with hardly any artifacts. The postcontrast image shows enhancement of the aneurysm wall, intramural hematoma, and stented artery. The image quality score assigned by the 2 reviewers for TOF-MRA and 3D T1WI SPACE is 2/2 and 5/5, respectively.
- FIG 3.
Follow-up images of a left vertebral artery dissecting aneurysm treated with Enterprise stent-assisted coiling at the sixth month postoperatively. A, DSA shows fusiform dilation (white arrows) of the left vertebral artery. The aneurysm is diagnosed as having incomplete occlusion. Arrowheads indicate the stent edges. B, The MIP image of TOF-MRA shows strong signal loss at the stented artery. The aneurysm remnant is not depicted. C and D, Pre- and postcontrast 3D T1-weighted SPACE shows a fusiform dilation of the parent artery, similar to the DSA findings. The aneurysm is classified as having incomplete occlusion on 3D T1-weighted SPACE. The postcontrast image shows mild enhancement of the stented artery. The image quality score for TOF-MRA and 3D T1-weighted SPACE is 1/1 and 5/5, respectively.
Tables
Parameters TOF-MRA 3D T1-Weighted SPACE TR (ms) 21 900 TE (ms) 3.43 16 Flip angle 18° – FOV (mm) 180 × 180 200 × 200 Matrix 320 × 320 384 × 384 No. of excitations 1 1 Section thickness (mm) 0.55 0.53 No. of slices 162 256 Echo-train length – 293 Scanning time (min) 4:05 9:18 Note:—The en dash indicates not applicable.
DSA κ (95% CI) InCO CO Total TOF-MRA 0.794 (0.579–1.0) InCO 12 0 12 CO 3 14 17 Total 15 14 29 HR-VW-MR imaging 0.525 (0.255–0.794) InCO 8 0 8 CO 7 14 21 Total 15 14 29 TOF-MRA combined with HR-VW-MR imaging 0.931 (0.799–1.0) InCO 14 0 14 CO 1 14 15 Total 15 14 29 Note:—CO indicates complete occlusion; InCO, incomplete occlusion.
- Table 3:
Diagnostic performance of TOF-MRA, HR-VW-MR imaging, and HR-VW-MR imaging combined with TOF-MRA in the assessment of aneurysm occlusion status
Sensitivity Specificity Positive Predictive Value Negative Predictive Value Accuracy TOF-MRA 80.0% 100.0% 100.0% 82.4% 89.7% HR-VW-MR imaging 53.30% 100.0% 100.0% 66.7% 75.9% HR-VW-MR imaging combined with TOF-MRA 93.3% 100.0% 100.0% 93.3% 96.6%
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