Imaging of Intracranial Saccular Aneurysms

Vascular imaging is an essential tool to appropriately diagnose and treat intracranial saccular aneurysms. There is extensive heterogeneity in aneurysm characteristics including location, size, shape, patient demographics, and clinical status that leads to a great diversity in both surgical and endovascular treatment options. This variability may elicit confusion when deciding the most appropriate imaging paradigm for an individual patient at particular time points. A collection of pre- and posttreatment scales and grades exist, but there is no current consensus on which one to implement. In this review, we discuss the key advantages and disadvantages of the available imaging modalities and how each can guide management. We also review novel imaging tools that are likely to alter the diagnostic landscape of intracranial aneurysms in the coming years.