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Suspected Metallic Embolization Distal to Coiled Intracranial Aneurysms Detectable by Susceptibility-Weighted MR
1From the Departments of Radiology (D.H.Y., Y.D.C., H.S.L., S.H.K., M.H.H.), and.
AJNR. American Journal of Neuroradiology
|April 11, 2020
Summary
Particulate metal lesions may appear after cerebral aneurysm coiling, detected via susceptibility-weighted imaging (SWI). These findings, though common, do not appear to cause neurological symptoms in patients.
Area of Science:
- Neuroradiology
- Medical Imaging
- Interventional Neurology
Background:
- Endovascular coiling is a common treatment for intracranial aneurysms.
- Post-procedure MR imaging may reveal parenchymal lesions.
- These lesions are suspected to be particulate metal fragments.
Purpose of the Study:
- To assess the frequency of metallic particulate lesions after aneurysm coiling using SWI.
- To investigate the potential causes of these lesions.
- To explore the clinical implications of these findings.
Main Methods:
- Retrospective review of 700 MR imaging studies of coiled intracranial aneurysms.
- Identification and measurement of dark-signal lesions (>5 mm) on SWI.
- Correlation with procedural devices and patient clinical records.
Main Results:
- Twenty patients (2.8%) had 25 lesions (median diameter 8 mm) on SWI.
- Lesions were typically downstream from aneurysms but within territories of guiding catheter use.
- No specific device was consistently linked, and no neurological symptoms were observed.
Conclusions:
- Distal embolization of particulate metal can occur after cerebral aneurysm coiling.
- These SWI-detectable lesions appear to have no significant clinical impact.
- The exact origin of the metallic particles requires further investigation.
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