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Research ArticleORIGINAL RESEARCH

Visualization of intracranial aneurysms treated with Woven EndoBridge (WEB) devices using Ultrashort Echo Time Magnetic Resonance Imaging (UTE-MRI)

Daniel Toth, Stefan Sommer, Riccardo Ludovichetti, Markus Klarhöfer, Jawid Madjidyar, Patrick Thurner, Marco Piccirelli, Miklos Krepuska, Tim Finkenstädt, Roman Guggenberger, Sebastian Winklhofer, Zsolt Kulcsar and Tilman Schubert
American Journal of Neuroradiology July 2024, ajnr.A8401; DOI: https://doi.org/10.3174/ajnr.A8401
Daniel Toth
From the Department of Neuroradiology, Clinical Neuroscience Center, University Hospital Zürich, Zürich, Switzerland (D.T., J.W., R.L., P.T., M.P., M.K., S.W., Z.K., T.S.), Siemens Healthcare, Zürich, Switzerland (S.S., M.K.), and Advanced Clinical Imaging Technology (ACIT), Siemens Healthcare, Lausanne, Switzerland (S.S.), Department of Radiology, University Hospital Zürich, Zürich, Switzerland (R.G., T.F.).
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Stefan Sommer
From the Department of Neuroradiology, Clinical Neuroscience Center, University Hospital Zürich, Zürich, Switzerland (D.T., J.W., R.L., P.T., M.P., M.K., S.W., Z.K., T.S.), Siemens Healthcare, Zürich, Switzerland (S.S., M.K.), and Advanced Clinical Imaging Technology (ACIT), Siemens Healthcare, Lausanne, Switzerland (S.S.), Department of Radiology, University Hospital Zürich, Zürich, Switzerland (R.G., T.F.).
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Riccardo Ludovichetti
From the Department of Neuroradiology, Clinical Neuroscience Center, University Hospital Zürich, Zürich, Switzerland (D.T., J.W., R.L., P.T., M.P., M.K., S.W., Z.K., T.S.), Siemens Healthcare, Zürich, Switzerland (S.S., M.K.), and Advanced Clinical Imaging Technology (ACIT), Siemens Healthcare, Lausanne, Switzerland (S.S.), Department of Radiology, University Hospital Zürich, Zürich, Switzerland (R.G., T.F.).
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Markus Klarhöfer
From the Department of Neuroradiology, Clinical Neuroscience Center, University Hospital Zürich, Zürich, Switzerland (D.T., J.W., R.L., P.T., M.P., M.K., S.W., Z.K., T.S.), Siemens Healthcare, Zürich, Switzerland (S.S., M.K.), and Advanced Clinical Imaging Technology (ACIT), Siemens Healthcare, Lausanne, Switzerland (S.S.), Department of Radiology, University Hospital Zürich, Zürich, Switzerland (R.G., T.F.).
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Jawid Madjidyar
From the Department of Neuroradiology, Clinical Neuroscience Center, University Hospital Zürich, Zürich, Switzerland (D.T., J.W., R.L., P.T., M.P., M.K., S.W., Z.K., T.S.), Siemens Healthcare, Zürich, Switzerland (S.S., M.K.), and Advanced Clinical Imaging Technology (ACIT), Siemens Healthcare, Lausanne, Switzerland (S.S.), Department of Radiology, University Hospital Zürich, Zürich, Switzerland (R.G., T.F.).
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Patrick Thurner
From the Department of Neuroradiology, Clinical Neuroscience Center, University Hospital Zürich, Zürich, Switzerland (D.T., J.W., R.L., P.T., M.P., M.K., S.W., Z.K., T.S.), Siemens Healthcare, Zürich, Switzerland (S.S., M.K.), and Advanced Clinical Imaging Technology (ACIT), Siemens Healthcare, Lausanne, Switzerland (S.S.), Department of Radiology, University Hospital Zürich, Zürich, Switzerland (R.G., T.F.).
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Marco Piccirelli
From the Department of Neuroradiology, Clinical Neuroscience Center, University Hospital Zürich, Zürich, Switzerland (D.T., J.W., R.L., P.T., M.P., M.K., S.W., Z.K., T.S.), Siemens Healthcare, Zürich, Switzerland (S.S., M.K.), and Advanced Clinical Imaging Technology (ACIT), Siemens Healthcare, Lausanne, Switzerland (S.S.), Department of Radiology, University Hospital Zürich, Zürich, Switzerland (R.G., T.F.).
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Miklos Krepuska
From the Department of Neuroradiology, Clinical Neuroscience Center, University Hospital Zürich, Zürich, Switzerland (D.T., J.W., R.L., P.T., M.P., M.K., S.W., Z.K., T.S.), Siemens Healthcare, Zürich, Switzerland (S.S., M.K.), and Advanced Clinical Imaging Technology (ACIT), Siemens Healthcare, Lausanne, Switzerland (S.S.), Department of Radiology, University Hospital Zürich, Zürich, Switzerland (R.G., T.F.).
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Tim Finkenstädt
From the Department of Neuroradiology, Clinical Neuroscience Center, University Hospital Zürich, Zürich, Switzerland (D.T., J.W., R.L., P.T., M.P., M.K., S.W., Z.K., T.S.), Siemens Healthcare, Zürich, Switzerland (S.S., M.K.), and Advanced Clinical Imaging Technology (ACIT), Siemens Healthcare, Lausanne, Switzerland (S.S.), Department of Radiology, University Hospital Zürich, Zürich, Switzerland (R.G., T.F.).
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Roman Guggenberger
From the Department of Neuroradiology, Clinical Neuroscience Center, University Hospital Zürich, Zürich, Switzerland (D.T., J.W., R.L., P.T., M.P., M.K., S.W., Z.K., T.S.), Siemens Healthcare, Zürich, Switzerland (S.S., M.K.), and Advanced Clinical Imaging Technology (ACIT), Siemens Healthcare, Lausanne, Switzerland (S.S.), Department of Radiology, University Hospital Zürich, Zürich, Switzerland (R.G., T.F.).
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Sebastian Winklhofer
From the Department of Neuroradiology, Clinical Neuroscience Center, University Hospital Zürich, Zürich, Switzerland (D.T., J.W., R.L., P.T., M.P., M.K., S.W., Z.K., T.S.), Siemens Healthcare, Zürich, Switzerland (S.S., M.K.), and Advanced Clinical Imaging Technology (ACIT), Siemens Healthcare, Lausanne, Switzerland (S.S.), Department of Radiology, University Hospital Zürich, Zürich, Switzerland (R.G., T.F.).
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Zsolt Kulcsar
From the Department of Neuroradiology, Clinical Neuroscience Center, University Hospital Zürich, Zürich, Switzerland (D.T., J.W., R.L., P.T., M.P., M.K., S.W., Z.K., T.S.), Siemens Healthcare, Zürich, Switzerland (S.S., M.K.), and Advanced Clinical Imaging Technology (ACIT), Siemens Healthcare, Lausanne, Switzerland (S.S.), Department of Radiology, University Hospital Zürich, Zürich, Switzerland (R.G., T.F.).
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Tilman Schubert
From the Department of Neuroradiology, Clinical Neuroscience Center, University Hospital Zürich, Zürich, Switzerland (D.T., J.W., R.L., P.T., M.P., M.K., S.W., Z.K., T.S.), Siemens Healthcare, Zürich, Switzerland (S.S., M.K.), and Advanced Clinical Imaging Technology (ACIT), Siemens Healthcare, Lausanne, Switzerland (S.S.), Department of Radiology, University Hospital Zürich, Zürich, Switzerland (R.G., T.F.).
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ABSTRACT

BACKGROUND AND PURPOSE: Assessing treatment success of intracranial aneurysms treated with Woven EndoBridge (WEB) devices using MRI is important in follow-up imaging. Depicting both the device configuration as well as reperfusion is challenging due to susceptibility artefacts. We evaluated the usefulness of contrast-enhanced 3D-Ultrashort Echo-Time (UTE) sequence in this setting.

MATERIALS AND METHODS: In this prospective study, 12 patients (9 female) with 15 treated aneurysms were included. These 12 patients underwent 18 MRI examinations. Follow-up UTE-MRI controls were performed on the same 3-Tesla scanner. We compared the visualization of device configuration, artifact-related virtual stenosis of the parent vessel and WEB occlusion scale in 3D isotropic UTE-MRI post-contrast with standard time-of-flight (TOF) MR-angiography with (CE) and without intravenous contrast as well as DSA. Two interventional neuroradiologists rated the images separately and in consensus.

RESULTS: Visualization of the WEB device position and configuration was rated superior or highly superior using the UTE sequence in 17/18 MRIs compared to TOF-MRA. Artifact-related virtual stenosis of the parent vessel was significantly lower in UTE-MRI compared to TOF and CE-TOF. Reperfusion was visible in 8/18 controls in DSA. TOF was able to grade reperfusion correctly in 16 cases, CE-TOF in 16 cases and UTE in 17 cases.

CONCLUSIONS: Contrast-enhanced UTE is a novel MRI sequence that shows benefit compared to standard sequences in non-invasive and radiation-free follow-up imaging of intracranial aneurysms treated using the WEB-device.

ABBREVIATIONS: ACoA = anterior communicating artery, BA = basilar artery, CEA = contrast enhanced angiography, ICA = internal carotid artery, MCA = middle cerebral artery, PCom = posterior communicating artery TOF-CE = contrast enhanced time-of-flight angiography, UTE = ultra-short echo time, WEB = woven endobridge

  • © 2024 by American Journal of Neuroradiology
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Accepted Manuscript
Daniel Toth, Stefan Sommer, Riccardo Ludovichetti, Markus Klarhöfer, Jawid Madjidyar, Patrick Thurner, Marco Piccirelli, Miklos Krepuska, Tim Finkenstädt, Roman Guggenberger, Sebastian Winklhofer, Zsolt Kulcsar, Tilman Schubert
Visualization of intracranial aneurysms treated with Woven EndoBridge (WEB) devices using Ultrashort Echo Time Magnetic Resonance Imaging (UTE-MRI)
American Journal of Neuroradiology Jul 2024, ajnr.A8401; DOI: 10.3174/ajnr.A8401

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Accepted Manuscript
Visualization of intracranial aneurysms treated with Woven EndoBridge (WEB) devices using Ultrashort Echo Time Magnetic Resonance Imaging (UTE-MRI)
Daniel Toth, Stefan Sommer, Riccardo Ludovichetti, Markus Klarhöfer, Jawid Madjidyar, Patrick Thurner, Marco Piccirelli, Miklos Krepuska, Tim Finkenstädt, Roman Guggenberger, Sebastian Winklhofer, Zsolt Kulcsar, Tilman Schubert
American Journal of Neuroradiology Jul 2024, ajnr.A8401; DOI: 10.3174/ajnr.A8401
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