gms | German Medical Science

62nd Annual Meeting of the German Society of Neurosurgery (DGNC)
Joint Meeting with the Polish Society of Neurosurgeons (PNCH)

German Society of Neurosurgery (DGNC)

7 - 11 May 2011, Hamburg

Non-invasive visualization of cerebral standard EC-/IC-bypasses with non-contrast 4D-MR angiography: A comparison with digital subtraction angiography (DSA)

Meeting Abstract

  • M.A. Kamp - Klinik für Neurochirurgie, Heinrich-Heine-Universität, Düsseldorf, Germany
  • R.S. Lanzman - Institut für Radiologie, Heinrich-Heine-Universität, Düsseldorf
  • P. Schmitt - Institut für Radiologie, Heinrich-Heine-Universität, Düsseldorf; Siemens
  • G. Antoch - Institut für Radiologie, Heinrich-Heine-Universität, Düsseldorf
  • D. Blondin - Institut für Radiologie, Heinrich-Heine-Universität, Düsseldorf
  • H.J. Steiger - Klinik für Neurochirurgie, Heinrich-Heine-Universität, Düsseldorf, Germany
  • D. Hänggi - Klinik für Neurochirurgie, Heinrich-Heine-Universität, Düsseldorf, Germany

Deutsche Gesellschaft für Neurochirurgie. Polnische Gesellschaft für Neurochirurgen. 62. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit der Polnischen Gesellschaft für Neurochirurgen (PNCH). Hamburg, 07.-11.05.2011. Düsseldorf: German Medical Science GMS Publishing House; 2011. DocP 006

doi: 10.3205/11dgnc227, urn:nbn:de:0183-11dgnc2273

Published: April 28, 2011

© 2011 Kamp et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.



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.