Higo Yoichi, Komagata Sakura, Katsuki Masahito, Kawamura Shin, Koh Akihito
Department of Radiological Technology, Itoigawa General Hospital, Itoigawa, JPN.
Department of Neurosurgery, Itoigawa General Hospital, Itoigawa, JPN.
Cureus. 2021 Jul 25;13(7):e16611. doi: 10.7759/cureus.16611. eCollection 2021 Jul.
Cerebral aneurysm and mother artery assessment after clipping is essential to evaluate aneurysm remnant, regrowth, and clip slippage. Usually, cerebral angiography and contrast-enhanced computed tomography angiography (CTA) are used for the evaluation, but they have the side effect of contrast medium and are time-consuming. Time-of-flight magnetic resonance angiography (TOF-MRA) is a non-invasive and fast modality, but clip-induced artifacts limit the signal near the metal clip. Recent ultrashort echo time (UTE)-MRA reduces metal artifacts but its availability is still low worldwide. Therefore, we developed a modified TOF-MRA sequence, named short TE-MRA, using Optima MR 360 1.5T Advance (GE Healthcare Life Sciences, Buckinghamshire, UK). It could describe the artery near the clip using general MRA equipment without recent UTE-MRA technology. We present a subarachnoid hemorrhage patient who underwent short TE-MRA about a year after clipping for the aneurysms at the bilateral internal carotid arteries. Short TE-MRA described the left internal carotid, middle cerebral, and anterior cerebral arteries. The right middle and anterior cerebral arteries were described, but the right internal carotid artery was not. Normal TOF-MRA could not describe them. Without recent UTE-MRA technology, short TE-MRA might be an alternative method for evaluating the artery near the clip. Short TE-MRA can be performed by general MRA equipment with a little time, so it may be helpful until UTE-MRA is widely used. Further research is needed on whether short TE-MRA can describe the aneurysm remnant, regrowth, and clip slippage up to the clinically useful level.
夹闭术后的脑动脉瘤及母动脉评估对于评估动脉瘤残留、再生长及夹子移位至关重要。通常,脑血管造影和对比增强计算机断层血管造影(CTA)用于评估,但它们有造影剂副作用且耗时。时间飞跃磁共振血管造影(TOF-MRA)是一种无创且快速的检查方式,但夹子引起的伪影会限制金属夹附近的信号。近期的超短回波时间(UTE)-MRA减少了金属伪影,但其在全球的可用性仍然较低。因此,我们使用Optima MR 360 1.5T Advance(GE医疗生命科学公司,英国白金汉郡)开发了一种改良的TOF-MRA序列,称为短TE-MRA。它可以使用普通MRA设备描述夹子附近的动脉,而无需最新的UTE-MRA技术。我们报告了一名蛛网膜下腔出血患者,其双侧颈内动脉动脉瘤夹闭术后约一年接受了短TE-MRA检查。短TE-MRA显示了左侧颈内动脉、大脑中动脉和大脑前动脉。右侧大脑中动脉和大脑前动脉也能显示,但右侧颈内动脉未显示。普通TOF-MRA无法显示这些血管。在没有最新UTE-MRA技术的情况下,短TE-MRA可能是评估夹子附近动脉的一种替代方法。短TE-MRA可以由普通MRA设备在短时间内完成,因此在UTE-MRA广泛应用之前可能会有所帮助。关于短TE-MRA能否在临床上有用的水平描述动脉瘤残留、再生长及夹子移位,还需要进一步研究。