Use of Pointwise Encoding Time Reduction with Radial Acquisition Magnetic Resonance Angiography for Coil Embolization

It is imperative to perform imaging evaluation following endovascular coil treatment for cerebral aneurysms. Noninvasive vascular assessment using Magnetic Resonance Angiography (MRA), specifically Time-of-Flight (TOF) MRA, is commonly performed. Thus, this study assessed the diagnostic performance of Pointwise Encoding Time Reduction with Radial Acquisition (PETRA) MRA in patients who underwent simple coil embolization.

Occlusion status, overall image quality, and treated-site image quality were compared across Digital Subtraction Angiography (DSA), TOF MRA, and PETRA MRA obtained during the same follow-up session after simple coil embolization of intracranial aneurysms.

Overall, 366 patients (median age: 61 ± 13 years) with 373 aneurysms underwent DSA, TOF MRA, and PETRA MRA following simple coil embolization. Occlusion status on PETRA MRA (85 cases, 91.4%) revealed stronger consistency with DSA than with TOF MRA (60 cases, 64.5%). Moreover, PETRA MRA demonstrated higher sensitivity for detecting residual neck and aneurysm (Raymond II and IIIa) compared with TOF MRA (Raymond II: 89% vs. 69%, p < 0.05; Raymond IIIa: 93% vs. 50%, p < 0.05). Notably, no significant differences were observed in overall or treated-site image quality between the techniques (p = 0.9).

PETRA MRA provides better visualization of residual flow within the coil mass and exhibits greater agreement with DSA than with TOF MRA. It also serves as an effective follow-up imaging modality, preserving image quality while enhancing diagnostic accuracy.

PETRA MRA offers superior diagnostic performance compared with TOF MRA for follow-up evaluation following simple coil embolization of cerebral aneurysms.