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使用超短回波时间磁共振成像对采用编织型内桥装置治疗的颅内动脉瘤进行可视化研究。

Visualization of Intracranial Aneurysms Treated with Woven EndoBridge Devices Using Ultrashort TE MR Imaging.

作者信息

Toth Daniel, Sommer Stefan, Ludovichetti Riccardo, Klarhoefer Markus, Madjidyar Jawid, Thurner Patrick, Piccirelli Marco, Krepsuka Miklos, Finkenstädt Tim, Guggenberger Roman, Winklhofer Sebastian, Kulcsar Zsolt, Schubert Tilman

机构信息

From the Department of Neuroradiology (D.T., R.L., J.M., P.T., M.P., M.K., T.F., S.W., Z.K., T.S.), Clinical Neuroscience Center, University Hospital Zurich, Zurich, Switzerland.

Siemens Healthcare (S.S., M.K.), Zurich, Switzerland.

出版信息

AJNR Am J Neuroradiol. 2025 Jan 8;46(1):107-112. doi: 10.3174/ajnr.A8401.

Abstract

BACKGROUND AND PURPOSE

Assessing the 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 artifacts. We evaluated the usefulness of the contrast-enhanced 3D ultrashort TE (UTE) sequence in this setting.

MATERIALS AND METHODS

In this prospective study, 12 patients (9 women) with 15 treated aneurysms were included. These 12 patients underwent 18 MRI examinations. Follow-up UTE-MRI controls were performed on the same 3T scanner. We compared the visualization of device configuration, artifact-related virtual stenosis of the parent vessel, and the WEB occlusion scale in 3D isotropic UTE-MRI postcontrast with standard TOF-MRA with contrast-enhancement (CE) and without IV 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 with TOF-MRA. Artifact-related virtual stenosis of the parent vessel was significantly lower in UTE-MRI compared with TOF and CE-TOF. Reperfusion was visible in 8/18 controls on 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 with the standard sequences in noninvasive and radiation-free follow-up imaging of intracranial aneurysms treated using the WEB device.

摘要

背景与目的

在随访成像中,使用磁共振成像(MRI)评估采用编织型血管内桥接(WEB)装置治疗的颅内动脉瘤的治疗效果非常重要。由于磁敏感伪影,描绘装置形态以及再灌注情况具有挑战性。我们评估了对比增强三维超短回波时间(UTE)序列在此情况下的实用性。

材料与方法

在这项前瞻性研究中,纳入了12例(9例女性)接受治疗的15个动脉瘤患者。这12例患者接受了18次MRI检查。在同一台3T扫描仪上进行随访UTE-MRI对照检查。我们将三维各向同性UTE-MRI造影后图像中装置形态的可视化、与伪影相关的载瘤血管虚拟狭窄以及WEB闭塞分级,与标准对比增强(CE)和非静脉注射对比剂的时间飞跃法磁共振血管造影(TOF-MRA)以及数字减影血管造影(DSA)进行比较。两位介入神经放射科医生分别独立对图像进行评分并达成共识。

结果

与TOF-MRA相比,在18次MRI检查中的17次中,使用UTE序列对WEB装置位置和形态的可视化被评为优或高度优。与TOF和CE-TOF相比,UTE-MRI中与伪影相关的载瘤血管虚拟狭窄明显更低。DSA显示18次对照检查中有8次出现再灌注。TOF能够正确分级再灌注的有16例;CE-TOF为16例;UTE为17例。

结论

对比增强UTE是一种新型MRI序列,在使用WEB装置治疗的颅内动脉瘤的无创、无辐射随访成像中,与标准序列相比显示出优势。

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