Improving diagnostic reliability of postoperative 3D TOF-MRA for cerebral aneurysms by optimizing the...

Area of Science:

• Medical Imaging
• Radiology
• Neuroimaging

Background:

• 3D TOF-MRA is crucial for postoperative cerebral aneurysm follow-up.
• Metallic artifacts from clips/coils can obscure arteries and hinder recanalization detection.
• Current methods face challenges with artifact-induced signal loss.

Purpose of the Study:

• To evaluate if optimizing the frequency-encoding direction enhances diagnostic reliability of 3D TOF-MRA.
• To compare artifact reduction and parent artery visualization between conventional and optimized MRA.
• To assess the clinical applicability of the optimized technique.

Main Methods:

• Nine patients with surgically clipped cerebral aneurysms underwent both conventional MRA (c-MRA) and optimized MRA (o-MRA).
• Radiographers qualitatively assessed parent artery visualization near clips using a Likert scale.
• Quantitative analysis measured artifact dimensions in three patients with o-MRA in AP and RL directions.

Main Results:

• Optimized MRA (o-MRA) showed significantly better parent artery visualization than conventional MRA (c-MRA) (p < 0.01).
• Interobserver agreement was excellent for both techniques (κ=0.80 for c-MRA, κ=0.89 for o-MRA).
• Quantitative analysis confirmed artifacts elongated along the frequency-encoding direction.

Conclusions:

• Optimizing frequency-encoding direction effectively controls susceptibility artifacts in 3D TOF-MRA.
• This technique significantly improves diagnostic reliability for postoperative aneurysm follow-up.
• The method is practical, requiring no extra sequences, hardware, or scan time for immediate clinical implementation.