gms | German Medical Science

63rd Annual Meeting of the German Society of Neurosurgery (DGNC)
Joint Meeting with the Japanese Neurosurgical Society (JNS)

German Society of Neurosurgery (DGNC)

13 - 16 June 2012, Leipzig

Follow-up of cerebral aneurysms after coil embolization with 3 Tesla MR-angiography

Meeting Abstract

  • G.F. Götz - Institut für Diagnostische und Interventionelle Neuroradiologie, Medizinische Hochschule Hannover
  • B. Hong - Klinik für Neurochirurgie, Medizinische Hochschule Hannover
  • A. Giesemann - Institut für Diagnostische und Interventionelle Neuroradiologie, Medizinische Hochschule Hannover
  • J.M. Lang - Klinik für Neurochirurgie, Medizinische Hochschule Hannover
  • P. Raab - Institut für Diagnostische und Interventionelle Neuroradiologie, Medizinische Hochschule Hannover
  • J.K. Krauss - Klinik für Neurochirurgie, Medizinische Hochschule Hannover
  • M. Nakamura - Klinik für Neurochirurgie, Medizinische Hochschule Hannover

Deutsche Gesellschaft für Neurochirurgie. Japanische Gesellschaft für Neurochirurgie. 63. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit der Japanischen Gesellschaft für Neurochirurgie (JNS). Leipzig, 13.-16.06.2012. Düsseldorf: German Medical Science GMS Publishing House; 2012. DocP 056

DOI: 10.3205/12dgnc443, URN: urn:nbn:de:0183-12dgnc4432

Published: June 4, 2012

© 2012 Götz et al.
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Outline

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Objective: To correlate DSA and MRA-findings at 3 Tesla in the follow-up of patients after coil embolisation of cerebral aneurysms.

Methods: Fourteen female and two male patients 21 to 73 years old with 18 aneurysms were evaluated with a 3 Tesla system “Verio” (Siemens) in the follow-up after coiling. Ten aneurysms were located in the vertebro-basilar system, two at the posterior communicating artery and four in the anterior part of the circle of Willis. Five patients had been treated with stents in addition to coils. Follow-up angiography was done 6 years to 4 months after initial coiling. MRA and DSA were carried out within 24 hours. Analysis of DSA (4 vessel angiography and 3D-angiography) and MRA (source images, MIP-reformations) was done on a PACS-workstation (GE Medical). Two neuroradiologists rated independently image quality of DSA and MRA, adequacy of anatomical depiction and aneurysm remnant.

Results: All MRA were of high quality, partial obscuration of the aneurysm as a result of an implanted stent occured in two patients. Three aneurysms were totally occluded, in the remaining, reperfusion ranged from 2 to 5 mm. DSA was of good quality in all patients, 3D-angiography was available in 8 patients. Aneurysm remnants were equally rated in 15 aneurysms, in 3 MRA was superior due to limited DSA projections.

Conclusions: In our experience MRA at 3 Tesla is a powerful alternative to DSA in the follow-up of aneurysms after coil embolisation. Signal loss around stents at the base of aneurysms is a severe limitation at times. In all other cases we prefer MRA for long-term follow-up and change to DSA only in case of progressive recanalisation.