gms | German Medical Science

67. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC)
Joint Meeting mit der Koreanischen Gesellschaft für Neurochirurgie (KNS)

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

12. - 15. Juni 2016, Frankfurt am Main

Non-enhanced magnetic resonance imaging of unruptured intracranial aneurysms at 7 Tesla: comparison to the gold standard

Meeting Abstract

  • Toshinori Matsushige - Klinik für Neurochirurgie, Universitätsklinik Essen, Essen, Germany; Erwin L. Hahn Institute for Magnetic Resonance Imaging, Universität Duisburg-Essen, Essen, Germany; Department of Neurosurgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
  • Philipp Damman - Klinik für Neurochirurgie, Universitätsklinik Essen, Essen, Germany; Erwin L. Hahn Institute for Magnetic Resonance Imaging, Universität Duisburg-Essen, Essen, Germany
  • Harald H. Quick - Erwin L. Hahn Institute for Magnetic Resonance Imaging, Universität Duisburg-Essen, Essen, Germany; High Field and Hybrid MR Imaging, Universität Duisburg-Essen, Essen, Germany
  • Ulrich Sure - Klinik für Neurochirurgie, Universitätsklinik Essen, Essen, Germany
  • Marc Schlamann - Institut für Neuroradiologie, Universitätsklinikum Gießen und Marburg, Gießen, Germany; Institut für Diagnostische und Interventionelle Radiologie und Neuroradiologie, Universitätsklinik Essen, Essen, Germany
  • Karsten H. Wrede - Klinik für Neurochirurgie, Universitätsklinik Essen, Essen, Germany; Erwin L. Hahn Institute for Magnetic Resonance Imaging, Universität Duisburg-Essen, Essen, Germany

Deutsche Gesellschaft für Neurochirurgie. 67. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), 1. Joint Meeting mit der Koreanischen Gesellschaft für Neurochirurgie (KNS). Frankfurt am Main, 12.-15.06.2016. Düsseldorf: German Medical Science GMS Publishing House; 2016. DocDI.09.01

doi: 10.3205/16dgnc144, urn:nbn:de:0183-16dgnc1446

Veröffentlicht: 8. Juni 2016

© 2016 Matsushige et al.
Dieser Artikel ist ein Open-Access-Artikel und steht unter den Lizenzbedingungen der Creative Commons Attribution 4.0 License (Namensnennung). Lizenz-Angaben siehe http://creativecommons.org/licenses/by/4.0/.


Gliederung

Text

Objective: To prospectively evaluate time-of-flight (TOF) magnetic resonance angiography (MRA) and magnetization-prepared rapid acquisition gradient-echo (MPRAGE) at 7 Tesla for delineation of unruptured intracranial aneurysms (UIAs) in comparison to digital subtraction angiography (DSA).

Method: Forty patients with single or multiple UIAs were enrolled in this trial. Sequences acquired at 7 Tesla were TOF MRA and non-contrast-enhanced MPRAGE. All patients additionally underwent 3D DSA. Two experienced raters individually analyzed the following five aneurysm and image features on a five-point scale in 2D and 3D image reconstructions: delineation of parent vessel, dome and neck; overall image quality; and presence of artifacts. Interobserver accordance was analyzed for all ratings.

Results: The study group comprised 40 neurosurgical patients (male n = 15, female n = 25; average age 58 years, standard error of the mean 1.6; range 38 - 80 years). All 7 Tesla MRI examinations and DSA were performed successfully without any relevant side effects. Both readers identified 64 UIA in all 2D and 3D image reconstructions of 7 Tesla TOF MRA and 7 Tesla MPRAGE imaging as well as in DSA. Combined 7 Tesla and DSA ratings were excellent without significant differences between the visualization methods. Both ratings were significantly higher than for all individual MRI reconstructions (2D TOF MRA, 3D TOF MRA, 2D MPRAGE and 3D MPRAGE) for all evaluated aneurysm and image features. Ratings for 2D MPRAGE and 3D TOF MRA were significantly lower, but still good to excellent for most evaluated aneurysm and image features. Evaluation of 2D TOF MRA and 3D MPRAGE resulted in the lowest ratings with a good average, but poor or non-diagnostic ratings for few specific aneurysms. For the majority of ratings (n = 27) interobserver accordance was almost perfect and the remaining ratings (n = 3) showed substantial interobserver accordance.

Conclusions: This study demonstrates excellent delineation of UIAs using 7 Tesla MRA within a clinical setting comparable to the gold standard, DSA. The combination of 7 Tesla non-enhanced MPRAGE and TOF MRA for assessment of untreated UIAs is a promising clinical application of ultra-high-field MRA.