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Flow artifact in the anterior communicating artery resembling aneurysm on the time of flight MR angiogram

Deepak Takhtani1, Sathish Dundamadappa2, Ajit S Puri2

  • 1Department of Radiology, University of Massachusetts Medical School, UMass Memorial Hospital, Worcester, MA, USA deepak.takhtani@umassmemorial.org.

Acta Radiologica (Stockholm, Sweden : 1987)
|January 14, 2014
PubMed
Abstract

Insights

Time-of-flight MRA can create artifacts mimicking aneurysms in the anterior communicating artery (ACOM). These pseudoaneurysms have a tapered appearance and require further non-invasive testing for accurate diagnosis.

Area of Science:

  • Neuroradiology
  • Medical Imaging
  • Vascular Imaging

Background:

  • Magnetic Resonance Angiography (MRA) is a common non-invasive brain imaging technique for aneurysm detection.
  • MRA accuracy is lower than digital subtraction angiography and susceptible to false positives/negatives.
  • Potential causes of false negatives include hemorrhage, lipoma, dermoid, pituitary gland posterior lobe, and flow artifacts.

Purpose of the Study:

  • To detail pseudoaneurysm findings on time-of-flight MRA in the anterior communicating artery (ACOM).
  • To review the underlying physical principles of these MRA artifacts.

Main Methods:

  • Analysis of four patients with suspected ACOM aneurysms on time-of-flight MRA.
  • Follow-up imaging with catheter angiography or computed tomography angiography.

Main Results:

  • No true aneurysms were confirmed in any of the four patients.
  • All patients demonstrated normal anterior communicating arteries on confirmatory imaging.
  • The suspicious findings on MRA were identified as artifacts, specifically pseudoaneurysms with a tapered appearance.

Conclusions:

  • MRA can produce artifacts in the ACOM region that mimic aneurysms.
  • These pseudoaneurysms possess a characteristic tapered appearance.
  • Further non-invasive testing is recommended for suspected ACOM pseudoaneurysms identified on MRA.
Keywords:
Magnetic resonance angiography (MRA)anterior communicating artery (ACOM)artifactpseudoaneurysmturbulent flow

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