Takano N, Suzuki M, Irie R, Yamamoto M, Teranishi K, Yatomi K, Hamasaki N, Kumamaru K K, Hori M, Oishi H, Aoki S
From the Department of Radiology (N.T., M.S., K.K.K., M.H., S.A.), Graduate School of Medicine, Juntendo University, Tokyo, Japan
Department of Radiology (N.T., M.S., R.I., N.H., K.K.K., M.H., S.A.), Juntendo University Hospital, Tokyo, Japan.
AJNR Am J Neuroradiol. 2017 Aug;38(8):1610-1616. doi: 10.3174/ajnr.A5223. Epub 2017 May 18.
The Low-Profile Visualized Intraluminal Support Device comprises a small-cell nitinol structure and a single-wire braided stent that provides greater metal coverage than previously reported intracranial stents, as well as assumed strong susceptibility artifacts. This study aimed to assess the benefits of non-contrast-enhanced MRA by using a Silent Scan (Silent MRA) for intracranial anterior circulation aneurysms treated with Low-Profile Visualized Intraluminal Support Device stents.
Thirty-one aneurysms treated with Low-Profile Visualized Intraluminal Support Device stents were assessed by using Silent MRA, 3D TOF-MRA, and x-ray DSA. The quality of MRA visualization of the reconstructed artery was graded on a 4-point scale from 1 (not visible) to 4 (excellent). Aneurysm occlusion status was evaluated by using a 2-grade scale (total occlusion/remnant [neck or aneurysm]). Weighted κ statistics were used to evaluate interobserver and intermodality agreement.
The mean scores ± SDs for Silent MRA and 3D TOF-MRA were 3.16 ± 0.79 and 1.48 ± 0.67 ( < .05), respectively, with substantial interobserver agreement (κ = 0.66). The aneurysm occlusion rates of the 2-grade scale (total occlusion/remnant [neck or aneurysm]) were 69%/31% for DSA, 65%/35% for Silent MRA, and 92%/8% for 3D TOF-MRA, respectively. The intermodality agreements were 0.88 and 0.30 for DSA/Silent MRA and DSA/3D TOF-MRA, respectively.
Silent MRA seems to be useful for visualizing intracranial anterior circulation aneurysms treated with Low-Profile Visualized Intraluminal Support Device stents.
低轮廓可视化腔内支撑装置由一个小单元镍钛诺结构和一个单线编织支架组成,该支架比先前报道的颅内支架具有更大的金属覆盖率,并且可能会产生明显的磁化率伪影。本研究旨在评估使用静音扫描(Silent MRA)进行非增强磁共振血管造影(MRA)对采用低轮廓可视化腔内支撑装置支架治疗的颅内前循环动脉瘤的益处。
使用Silent MRA、三维时间飞跃法磁共振血管造影(3D TOF-MRA)和X线数字减影血管造影(DSA)对31个采用低轮廓可视化腔内支撑装置支架治疗的动脉瘤进行评估。对重建动脉的MRA可视化质量按4分制进行分级,从1分(不可见)到4分(优秀)。使用加权κ统计量评估观察者间和不同模态间的一致性。
Silent MRA和3D TOF-MRA的平均评分±标准差分别为3.16±0.79和1.48±0.67(P<0.05),观察者间一致性良好(κ=0.66)。DSA、Silent MRA和3D TOF-MRA在2级分级(完全闭塞/残留[颈部或动脉瘤])下的动脉瘤闭塞率分别为69%/31%、65%/35%和92%/8%。DSA/Silent MRA和DSA/3D TOF-MRA的不同模态间一致性分别为0.88和0.30。
Silent MRA似乎有助于可视化采用低轮廓可视化腔内支撑装置支架治疗的颅内前循环动脉瘤。