Artikel
Non-invasive visualization of cerebral standard EC-/IC-bypasses with non-contrast 4D-MR angiography: A comparison with digital subtraction angiography (DSA)
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Veröffentlicht: | 28. April 2011 |
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Gliederung
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Objective: The objective was to evaluate the patency of cerebral bypass surgery using nonenhanced time-resolved 4D ECG-gated time-resolved 4D Steady-state free precession (SSFP) MR angiography (MRA) for dynamic visualization of EC-/IC-bypasses.
Methods: 9 patients (mean 41 y; 37-70 y) who underwent surgery for an extracranial-intracranial (bypass EC-/IC-bypass) for a steno-occlusive disease of brain-supplying arteries (n = 6) or moya moya disease (n = 4) were included in this study. Two patients had previously undergone EC-/IC-bypass surgery on the contralateral side. 4D SSFP MRA of the intracranial arteries was acquired with 15 temporal phases and a temporal resolution of 115 ms on a 1.5T MR scanner. ECG-gated image acquisition was performed with increasing trigger times following spatially selective and non-selective inversion (FAIR technique) to obtain time-resolved images. Cerebral DSA served as the reference standard and was available for all patients.
Results: Nonenhanced 4D SSFP MRA allowed for the visualization of blood flow in EC-/IC-bypasses in 10/11 EC-/IC-bypasses (90.9%). 4D SSFP MRA failed to identify one bypass in a patient with bilateral bypasses. In comparsion, cerebral DSA detected all patent cerebral bypasses. Therefore, 4D SSFP MRA showed a high sensitivity (92.3%) and specificity (100%) in detection of patency of EC-/IC-bypasses.
Conclusions: 4D SSFP MRA is a reliable and non-invasive tool for detecting the patency of EC-/IC-bypasses with high sensitivity and specificity. Therefore, 4D SSFP MRA might be an alternative for postoperative proof of bypass patency.