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Intracranial aneurysms treated with coil placement: test characteristics of follow-up MR angiography--multicenter

Joanna D Schaafsma1, Birgitta K Velthuis, Charles B L M Majoie

  • 1Department of Neurology, Rudolf Magnus Institute of Neuroscience, University Medical Center Utrecht, Utrecht, the Netherlands. j.d.schaafsma@umcutrecht.nl

Radiology
|May 28, 2010
PubMed

Insights

Magnetic resonance (MR) angiography demonstrates good diagnostic performance for assessing coiled aneurysms, showing potential to replace digital subtraction angiography (DSA) in follow-up. This study highlights MR angiography

Area of Science:

  • Neuroimaging
  • Vascular Surgery
  • Radiology

Background:

  • Cerebral aneurysms require effective follow-up after coil embolization.
  • Intraarterial digital subtraction angiography (DSA) is the current standard for assessing aneurysm occlusion.
  • Non-invasive imaging modalities are sought to reduce risks associated with DSA.

Purpose of the Study:

  • To evaluate the diagnostic accuracy of magnetic resonance (MR) angiography in determining the occlusion status of aneurysms treated with endovascular coils.
  • To compare the performance of different MR angiography techniques (time-of-flight vs. contrast-enhanced) and field strengths (1.5T vs. 3.0T).

Main Methods:

  • A multicenter study involving 311 patients with 343 aneurysms treated with coils.
  • Comparison of MR angiography (3.0T/1.5T TOF and contrast-enhanced) with intraarterial DSA as the reference standard.
  • Independent reader assessment of aneurysm occlusion and logistic regression analysis for discrepancies.

Main Results:

  • MR angiography showed a negative predictive value of 94% and specificity of 89% for detecting incomplete occlusion.
  • Sensitivity was 82% and positive predictive value was 69%.
  • Area under the ROC curve (AUC) was comparable across different MR techniques and field strengths, indicating similar diagnostic performance.

Conclusions:

  • Time-of-flight MR angiography at both 1.5T and 3.0T demonstrates good diagnostic performance for evaluating coiled aneurysms.
  • These findings support the potential of MR angiography as a replacement for intraarterial DSA in routine aneurysm follow-up.
  • Further validation may facilitate wider adoption of MR angiography in clinical practice.
Abstract

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