Three-dimensional time-of-flight MR angiography in the evaluation of cerebral aneurysms

R J Sevick1, J S Tsuruda, P Schmalbrock

  • 1Department of Radiology, University of California, San Francisco 94143-0628.

Insights

Three-dimensional (3D) time-of-flight (TOF) magnetic resonance angiography (MRA) effectively detects intracranial aneurysms. Combining MRA with spin echo MR provides adequate assessment, aiding screening and follow-up.

Area of Science:

  • Medical Imaging
  • Neuroradiology
  • Vascular Imaging

Background:

  • Intracranial aneurysms pose significant health risks.
  • Accurate diagnostic imaging is crucial for detection and management.
  • Three-dimensional (3D) time-of-flight (TOF) magnetic resonance angiography (MRA) is a developing technique for vascular assessment.

Purpose of the Study:

  • To evaluate the preliminary experience with 3D TOF MRA for assessing intra- and extracranial aneurysms.
  • To compare MRA findings with conventional angiography and spin echo MR.
  • To identify limitations and benefits of 3D TOF MRA in aneurysm detection.

Main Methods:

  • Retrospective review of six patients with aneurysms (five intracranial, one cervical carotid pseudoaneurysm).
  • Utilized a 3D rephased gradient recalled echo pulse sequence and maximum intensity projection (MIP) reconstruction.
  • Compared MRA with spin echo MR and conventional angiography regarding vessel visualization, aneurysm depiction, and artifacts.

Main Results:

  • All aneurysms were successfully detected using MRA.
  • Excellent anatomical correlation was observed between MRA and conventional angiography.
  • Identified limitations include loss of small vessel visualization, intraluminal signal loss in large vessels, and artifact issues with MIP reconstructions.

Conclusions:

  • 3D TOF MRA, combined with T1-weighted spin echo images, offers adequate assessment of aneurysms.
  • Comprehensive review of all MRA components is necessary for accurate interpretation.
  • MRA shows potential for screening asymptomatic patients and follow-up of treated aneurysms.

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