Artikel
Relationship between thrombus and aneurysm wall in partially thrombosed intracranial aneurysms visualised with 7T MPRAGE
Zusammenhang zwischen Thrombus und Aneurysmawand partiell thrombosierter intrakranieller Aneurysmen in der 7 Tesla MPRAGE
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Autoren
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Bixia Chen
- Universitätsklinikum Essen, Klinik für Neurochirurgie, Essen, Deutschland
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Taku Sato
- Universitätsklinikum Essen, Klinik für Neurochirurgie, Essen, Deutschland; Fukushima Medical University, Department of Neurosurgery, Fukushima, Japan
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Oliver Gembruch
- Universitätsklinikum Essen, Klinik für Neurochirurgie, Essen, Deutschland
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Ramazan Jabbarli
- Universitätsklinikum Essen, Klinik für Neurochirurgie, Essen, Deutschland
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Philipp Dammann
- Universitätsklinikum Essen, Klinik für Neurochirurgie, Essen, Deutschland
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Marvin Darkwah Oppong
- Universitätsklinikum Essen, Klinik für Neurochirurgie, Essen, Deutschland
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Daniela Pierscianek
- Universitätsklinikum Essen, Klinik für Neurochirurgie, Essen, Deutschland
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Kiyoshi Saito
- Fukushima Medical University, Department of Neurosurgery, Fukushima, Japan
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Ulrich Sure
- Universitätsklinikum Essen, Klinik für Neurochirurgie, Essen, Deutschland
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Karsten Henning Wrede
- Universitätsklinikum Essen, Klinik für Neurochirurgie, Essen, Deutschland
| Veröffentlicht: | 26. Juni 2020 |
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Gliederung
Text
Objective: Thrombosed intracranial aneurysms (ICA) are often associated with increased aneurysm wall instability. Recently, contrast enhancement in the aneurysm wall of thrombosed ICAs could be visualized in vivo using high-resolution gadolinium-enhanced 7 Tesla (T) magnetic resonance imaging (MRI). This in-vivo study aimed to investigate the relationship between thrombus characteristics and the aneurysm wall in partially thrombosed intracranial aneurysms using MPRAGE at 7T MRI.
Methods: The study cohort included fifteen patients (7 males, 8 females) with sixteen partially thrombosed ICAs. All subjects were evaluated utilizing a 7T whole-body MR system (MAGNETOM 7T, Siemens Healthcare GmbH, Erlangen, Germany) equipped with a 1/32-channel Tx/Rx head radiofrequency coil (Nova Medical, Wilmington, USA). The gradient system provides 40 mT/m maximum amplitude and a slew rate of 200 mT /m/ms. A modified 7T MPRAGE sequence was implemented. The signal intensity ratio in the thrombus was defined as the highest signal intensity in the thrombus divided by the signal intensity in the anterior corpus callosum. The signal intensity ratio in the thrombus was compared to the thickness of the aneurysm wall at 7T MPRAGE. Histopathological findings in six tissue samples were correlated with 7T MRI.
Results: The mean signal intensity ratio of thrombus was 0.97 (standard error of the mean 0.14, range 0.27-2.28). The mean thickness of the aneurysm wall was 1.25 mm (standard error of the mean 0.08, range 0.84-1.55 mm). The signal intensity ratio of thrombus significantly correlated with the thickness of the aneurysm wall (p < 0.01) (Figure 1 [Fig. 1]). The aneurysm walls with the highest signal intensity ratio of thrombus were significantly thicker. In the histopathological examinations, three cases with hypointensity of the thrombus in MPRAGE showed only a few macrophages in the thrombus and a thin, degenerated aneurysmal wall (Figure 2 [Fig. 2]). On the other hand, three cases with hyperintensity of the thrombus in the MPRAGE showed abundant macrophages in the thrombus.
Conclusion: In MPRAGE at 7T MRI, the signal intensity ratio of thrombus in partially thrombosed intracranial aneurysms correlates with aneurysm wall thickness and histologic features indicating wall instability.
