Differential Subsampling with Cartesian Ordering for Ultrafast High-Resolution MRA in the Assessment of Intracranial...

We aimed to evaluate the feasibility of an ultrafast whole head contrast-enhanced MRA (CE-MRA) in morphometric assessment of intracranial aneurysms in comparison to routinely used time-of-flight (TOF)-MRA.

In this prospective single institutional study, patients with known untreated intracranial aneurysm underwent MRA. Routine multislab TOF-MRA was obtained with a 3D voxel sizes of .6 × .6 × 1 (6-minute acquisition time). CE-MRA of whole head was obtained using Differential Subsampling with Cartesian Ordering (DISCO) and 2D Auto-calibrating Reconstruction for Cartesian imaging with a 3D voxel-sizes of .75 × .75 × 1 mm³ during a 6-second temporal resolution. Morphometric features of intracranial aneurysms, including size, aneurysm sac morphology, and the presence of intraluminal thrombosis, were assessed on both techniques. Statistical analysis was performed using a combination of Kappa test, Bland-Altman, and correlation coefficient analysis.

A total of 34 aneurysms in 28 patients were included. Aneurysm size measurements (mean ± SD) were similar between DISCO-MRA (4.1 ± 2.3 mm) and TOF-MRA (4.3 ± 2.8 mm) (P = .27). Bland-Altman analysis showed a mean difference of .4 mm and there was excellent correlation r = .91 (95% CI: .87-.96). In six aneurysms (17.6%), TOF-MRA was nonconfidant to exclude intraluminal thrombosis. In seven aneurysms (20%), TOF-MRA was unable or nonconfidant in depicting aneurysm sac morphology.

Described ultrafast high spatial-resolution MRA is superior to routinely used TOF-MRA in assessment of morphometric features of intracranial aneurysms, such as intraluminal thrombosis and aneurysm morphology, and is obtained in a fraction of the time (6 seconds).