gms | German Medical Science

57th Annual Meeting of the German Society of Neurosurgery
Joint Meeting with the Japanese Neurosurgical Society

German Society of Neurosurgery (DGNC)

11 - 14 May, Essen

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Diffusion-weighted MR-imaging in neuro-interventional procedures

MRT Diffusionsbildgebung vor und nach neurointerventionellen Eingriffen

Meeting Abstract

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  • corresponding author J. Reul - Klinik für Neuroradiologie, Kreiskrankenhaus Siegen
  • L. Schuster - Klinik für Neuroradiologie, Kreiskrankenhaus Siegen
  • M. Grond - Klinik für Neurologie, Kreiskrankenhaus Siegen

Deutsche Gesellschaft für Neurochirurgie. Japanische Gesellschaft für Neurochirurgie. 57. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e.V. (DGNC), Joint Meeting mit der Japanischen Gesellschaft für Neurochirurgie. Essen, 11.-14.05.2006. Düsseldorf, Köln: German Medical Science; 2006. DocSO.02.07

The electronic version of this article is the complete one and can be found online at: http://www.egms.de/en/meetings/dgnc2006/06dgnc170.shtml

Published: May 8, 2006

© 2006 Reul et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.

Outline

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Objective: After diagnostic DSA, DWI changes in control MR images are found with a frequency of up to 20% without clinical correlates. There are no clear data about the number and clinical importance of DWI changes found after neurointerventional treatment.

Methods: We evaluated the frequency and clinical significance of DWI changes for different vascular neurointerventional procedures during a two-year-period. DWI was performed 24 hours before and in between 48 hours after the procedure. The neurological status was documented independently by a neurologist before and after the intervention. Data were collected in a data base and the images were analyzed with regard to DWI changes in the DWI images with b-value of 1000 and the ADC maps on a standard 1.5 Tesla imager. Number, size and location of DWI lesions were documented. The image analysis was done separately by two experienced and trained neuroradiologists. Lesions in the dependend territory of the treated artery were collected and analyzed separately. In addition, a FLAIR sequence was performed and analyzed.

Results: A total of 500 patients was included. 234 patients underwent carotid stenting. 146 patients underwent aneurysm coiling. 37 patients had intracranial stenting for arteriosclerotic stenoses. The remaining patients underwent different types of intervention (AVM embolization, intracranial angioplasty, DAVF embolization). Of all these patients, 85% were examined completely pre- and post interventionally with MR-imaging. Our data suggest a different frequency of DWI lesions, when comparing dependent with independend vascular territories. DWI lesions after extracranial stenting were more frequent than for intracranial prodedures (stents / coils). Remodeling treatment of aneurysms is associated with a higher rate of DWI lesions than standard coiling. The detailed data will be presented and discussed with regard to the clinical findings.

Conclusions: DWI lesions after neurointerventional procedures provide a good information about the safety of the procedure. However, in most cases it is without clinical correlation and without correlation with the morphological FLAIR images, suggesting that it may be a transient finding in a very sensitive imaging tool.