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Updated: Sep 13, 2025

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A Comparability Study Between Intravenous Contrast-Enhanced Cone-Beam Computed Tomography (CBCT) and Magnetic

Man Cho Lee1, King Him Fung1, Shing Him Liu1

  • 1Queen Elizabeth Hospital, Hong Kong.

Diagnostics (Basel, Switzerland)
|July 29, 2025
PubMed

Insights

Intravenous contrast-enhanced computed tomography angiography (IV CBCT) and magnetic resonance angiography (MRA) are compared for intracranial aneurysm follow-up. IV CBCT shows superior image quality for stent-treated aneurysms, offering better assessment of residual neck and parent vessel status.

Area of Science:

  • Neuroradiology
  • Medical Imaging
  • Interventional Neurology

Background:

  • Magnetic Resonance Angiography (MRA) is standard for monitoring treated intracranial aneurysms, assessing residual neck and stent patency.
  • Intravenous Contrast-Enhanced Computed Tomography Angiography (IV CBCT) offers superior spatial resolution, potentially improving aneurysm follow-up.
  • This study compares the diagnostic image quality of IV CBCT versus MRA for intracranial aneurysm follow-up.

Purpose of the Study:

  • To investigate and compare the image quality of IV CBCT and MRA in the follow-up of treated intracranial aneurysms.
  • To evaluate the diagnostic performance of each modality across key imaging parameters.
  • To determine the optimal imaging technique for specific aneurysm treatment types.

Main Methods:

  • Prospective cohort study including 97 patients with 114 treated cerebral aneurysms.
  • Patients underwent both IV CBCT and MRA on the same day.
  • Two blinded neurointerventional radiologists assessed image quality using a five-point Likert scale, evaluating diagnostic values and artifacts. Intra- and inter-observer agreement were calculated.

Main Results:

  • Overall, IV CBCT and MRA showed comparable performance in assessing parent vessel status and artifact levels (p > 0.05).
  • MRA had a slight advantage in evaluating residual aneurysmal neck (p = 0.05).
  • IV CBCT demonstrated superior assessment of residual aneurysmal neck (OR = 16.0, p < 0.001) and parent vessel status (OR = 15.1, p < 0.001) with fewer artifacts (OR > 100, p < 0.001) for clipped aneurysms.
  • For stent-treated aneurysms, IV CBCT was superior for residual neck (OR > 20, p = 0.002) and parent vessel status (OR > 20, p = 0.002) with significantly fewer artifacts (OR > 20, p = 0.002).
  • IV CBCT outperformed MRA in evaluating stent struts and vessel wall status when MRA was non-diagnostic.

Conclusions:

  • Both IV CBCT and MRA have distinct strengths and roles in post-treatment intracranial aneurysm follow-up.
  • IV CBCT demonstrates superior efficacy in assessing intracranial aneurysms treated with stents or surgical clips, particularly regarding residual neck, parent vessel patency, and artifact reduction.
  • The findings support IV CBCT as a valuable tool, potentially replacing MRA in specific follow-up scenarios.
Keywords:
cone-beam computed tomographyintracranial aneurysmmagnetic resonance angiography

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