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Usefulness of contrast-enhanced and TOF MR angiography for follow-up after low-profile stent-assisted coil embolization of intracranial aneurysms.

作者信息

Akkaya Selcuk, Akca Onur, Arat Anıl, Peker Ahmet, Balci Sinan

机构信息

1 Department of Radiology, Kaçkar State Hospital, Rize, Turkey.

2 Department of Radiology, Güven Hospital, Ankara, Turkey.

出版信息

Interv Neuroradiol. 2018 Dec;24(6):655-661. doi: 10.1177/1591019918785910. Epub 2018 Jul 5.


DOI:10.1177/1591019918785910
PMID:29976108
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6259350/
Abstract

BACKGROUND: Low-profile, self-expandable stents are used to treat wide-neck aneurysms located on the smaller distal intracranial arteries. This study aimed to assess the usefulness of time-of-flight (TOF) and contrast-enhanced (CE) magnetic resonance angiography (MRA) for follow-up after LEO Baby stent (LBS)-assisted coil embolization. METHODS: Twenty-four aneurysms treated with LBS-assisted coil embolization were evaluated. Researchers reviewed TOF MRA and CE MRA images in terms of occlusion and stent patency. Aneurysm occlusion was graded according to Raymond-Roy classification as follows: total occlusion (grade 1), residual neck (grade 2), and residual aneurysm (grade 3). Stent patency was scored as follows: occlusion (1), stenosis (2), and normal (3). Interobserver and intermodality agreement values were determined by weighted kappa (κ) statistics. RESULTS: Intermodality and interobserver values of TOF MRA and CE MRA with digital subtraction angiography (DSA) were perfect (κ = 1.00, p < 0.001) in terms of aneurysm occlusion. Rate of stent occlusion and stenosis in DSA, TOF, and MRA, respectively, were as follows: 0 and 12.5%, 16.6 and 70.8%, and 0 and 62.5%. Intermodality agreement values of TOF MRA and CE MRA with DSA were insignificant in terms of stent patency (κ = 0.065, p = 0.27; κ = 0.158, p = 0.15, respectively). Interobserver agreement was substantial in both TOF MRA (κ = 0.71, p < 0.001) and CE MRA (κ = 0.64, p = 0.001). CONCLUSIONS: Both TOF and CE MRA techniques have strong concordance with DSA for the detection of aneurysm occlusion status. CE MRA can be used as a first-line noninvasive imaging modality due to its superiority to TOF MRA with respect to the visualization of in-stent signals.

摘要

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本文引用的文献

[1]
Intracranial Aneurysms Treated by Flow-Diverting Stents: Long-Term Follow-Up with Contrast-Enhanced Magnetic Resonance Angiography.

Cardiovasc Intervent Radiol. 2017-11

[2]
Non-Contrast-Enhanced Silent Scan MR Angiography of Intracranial Anterior Circulation Aneurysms Treated with a Low-Profile Visualized Intraluminal Support Device.

AJNR Am J Neuroradiol. 2017-8

[3]
A Comparison of Magnetic Resonance Angiography Techniques for the Evaluation of Intracranial Aneurysms Treated With Stent-assisted Coil Embolization.

Cureus. 2016-12-2

[4]
Usefulness of Non-Contrast-Enhanced MR Angiography Using a Silent Scan for Follow-Up after Y-Configuration Stent-Assisted Coil Embolization for Basilar Tip Aneurysms.

AJNR Am J Neuroradiol. 2017-3

[5]
Follow-up of intracranial aneurysms treated with stent-assisted coiling: Comparison of contrast-enhanced MRA, time-of-flight MRA, and digital subtraction angiography.

J Neuroradiol. 2017-2

[6]
Effects of Imaging Parameters on the Quality of Contrast-Enhanced MR Angiography of Cerebral Aneurysms Treated Using Stent-Assisted Coiling: A Phantom Study.

Magn Reson Med Sci. 2017-4-10

[7]
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J Neurointerv Surg. 2017-9

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J Neurointerv Surg. 2017-9

[9]
Flow Diversion in Middle Cerebral Artery Aneurysms: Is It Really an All-Purpose Treatment?

World Neurosurg. 2016-3

[10]
Stent-Assisted Coiling of Wide-Neck Intracranial Aneurysms Using Low-Profile LEO Baby Stents: Initial and Midterm Results.

AJNR Am J Neuroradiol. 2015-10

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