Takano N, Suzuki M, Irie R, Yamamoto M, Hamasaki N, Kamagata K, Kumamaru K K, Hori M, Oishi H, Aoki S
From the Department of Radiology (N.T., M.S., K. Kamagata, K.K. Kumamaru, M.H., S.A.), Graduate School of Medicine, Juntendo University, Tokyo, Japan
Department of Radiology (N.T., M.S., R.I., N.H., K. Kamagata, K.K. Kumamaru, M.H., S.A.), Juntendo University Hospital, Tokyo, Japan.
AJNR Am J Neuroradiol. 2017 Mar;38(3):577-581. doi: 10.3174/ajnr.A5033. Epub 2016 Dec 22.
Y-configuration stent-assisted coil embolization is used for treating wide-neck aneurysms. Noninvasive alternatives to x-ray DSA for follow-up after Y-configuration stent-assisted coil embolization treatment are required. This study aimed to assess the usefulness of non-contrast-enhanced MRA by using a Silent Scan (silent MRA) for follow-up after Y-configuration stent-assisted coil embolization for basilar tip aneurysms.
Seven patients treated with Y-configuration stent-assisted coil embolization for basilar tip aneurysms underwent silent MRA, 3D TOF-MRA, and DSA. Silent MRA and 3D TOF-MRA images were obtained during the same scan session on a 3T MR imaging system. Two neuroradiologists independently reviewed both types of MRA images and subjectively scored the flow in the stents on a scale of 1 (not visible) to 5 (nearly equal to DSA) by referring to the latest DSA image as a criterion standard. Furthermore, we evaluated the visualization of the neck remnant.
In all patients, the 2 observers gave a higher score for the flow in the stents on silent MRA than on 3D TOF-MRA. The average score ± standard deviation was 4.07 ± 0.70 for silent MRA and 1.93 ± 0.80 ( < .05) for 3D TOF-MRA. Neck remnants were depicted by DSA in 5 patients. In silent MRA, neck remnants were depicted in 5 patients, and visualization was similar to DSA; however, in 3D TOF-MRA, neck remnants were depicted in only 1 patient.
Silent MRA might be useful for follow-up after Y-configuration stent-assisted coil embolization.
Y形支架辅助弹簧圈栓塞术用于治疗宽颈动脉瘤。Y形支架辅助弹簧圈栓塞治疗后需要采用非侵入性替代X线数字减影血管造影(DSA)进行随访。本研究旨在评估使用静音扫描(静音MRA)的非增强MRA在Y形支架辅助弹簧圈栓塞基底动脉尖部动脉瘤后随访中的应用价值。
7例接受Y形支架辅助弹簧圈栓塞基底动脉尖部动脉瘤治疗的患者接受了静音MRA、三维时间飞跃法MRA(3D TOF-MRA)和DSA检查。在3T磁共振成像系统的同一次扫描过程中获取静音MRA和3D TOF-MRA图像。两名神经放射科医生独立回顾这两种MRA图像,并以最新的DSA图像作为标准对照,主观地对支架内血流情况按1分(不可见)至5分(几乎与DSA相同)进行评分。此外,我们评估了瘤颈残余的显示情况。
在所有患者中,两名观察者对静音MRA上支架内血流的评分均高于3D TOF-MRA。静音MRA的平均评分±标准差为4.07±0.70,3D TOF-MRA为1.93±0.80(P<0.05)。DSA显示5例患者存在瘤颈残余。在静音MRA中,5例患者显示有瘤颈残余,其显示情况与DSA相似;然而,在3D TOF-MRA中,仅1例患者显示有瘤颈残余。
静音MRA可能对Y形支架辅助弹簧圈栓塞术后的随访有用。