Differentiation between paraclinoid and cavernous sinus aneurysms with contrast-enhanced 3D constructive interference...

Area of Science:

• Neuroradiology
• Vascular Imaging
• Neuroimaging

Background:

• Differentiating paraclinoid and cavernous sinus aneurysms of the internal carotid artery (ICA) is crucial for treatment planning.
• Accurate localization impacts surgical and endovascular intervention strategies.

Purpose of the Study:

• To evaluate the utility of contrast-enhanced (CE) 3D constructive interference in steady state (CISS) MR imaging for distinguishing between paraclinoid and cavernous sinus aneurysms.
• To assess the accuracy of CE 3D-CISS in classifying aneurysms as intradural, partially intradural, or extradural.

Main Methods:

• 11 aneurysms in 10 female patients (52-66 years) underwent conventional and CE 3D-CISS MR imaging at 1.5T.
• Two neuroradiologists evaluated aneurysm location on CE 3D-CISS images, with surgical findings serving as the reference standard.
• Imaging characteristics of the cavernous sinus, CSF, and carotid artery were analyzed.

Main Results:

• Surgery revealed 5 intradural and 6 extradural aneurysms.
• CE 3D-CISS imaging accurately assessed 9 out of 11 aneurysms.
• High signal intensity contrast on CE 3D-CISS clearly delineated the boundaries of the CSF, cavernous sinus, and carotid artery.

Conclusions:

• CE 3D-CISS MR imaging is a valuable tool for differentiating paraclinoid and cavernous sinus aneurysms.
• The technique provides clear visualization of anatomical relationships critical for surgical decision-making.