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66th Annual Meeting of the German Society of Neurosurgery (DGNC)
Friendship Meeting with the Italian Society of Neurosurgery (SINch)

German Society of Neurosurgery (DGNC)

7 - 10 June 2015, Karlsruhe

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Vascular wall imaging of unruptured intracranial aneurysms with a hybrid opposite-contrast magnetic resonance angiography

Meeting Abstract

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  • Toshinori Matsushige - Department of Neurosurgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan; Department of Neurosurgery, University Hospital Essen, University Duisburg-Essen, Essen, Germany
  • Takahito Okazaki - Department of Neurosurgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
  • Katsuhiro Shinagawa - Department of Neurosurgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
  • Karsten H. Wrede - Department of Neurosurgery, University Hospital Essen, University Duisburg-Essen, Essen, Germany
  • Ulrich Sure - Department of Neurosurgery, University Hospital Essen, University Duisburg-Essen, Essen, Germany
  • Kaoru Kurisu - Department of Neurosurgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan

Deutsche Gesellschaft für Neurochirurgie. 66. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC). Karlsruhe, 07.-10.06.2015. Düsseldorf: German Medical Science GMS Publishing House; 2015. DocDI.04.02

doi: 10.3205/15dgnc112, urn:nbn:de:0183-15dgnc1126

Published: June 2, 2015

© 2015 Matsushige et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.

Outline

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Objective: The aim of the present study was to characterize the wall of unruptured intracranial aneurysms using a hybrid opposite-contrast magnetic resonance angiography (HOP-MRA) at 3 Tesla.

Method: Fourteen consecutive patients with 17 unruptured intracranial aneurysms undergoing clipping surgery were prospectively evaluated. All aneurysms were scanned preoperatively using high-resolution HOP-MRA at 3 Tesla. Intraoperative findings of atherosclerotic plaques in the aneurysms were classified into three grades: grade A (strongly deposited), grade B (partially deposited), and grade C (not deposited). The contrast ratio of the high-intensity regions were measured relative to the background low-intensity regions inside the carotid artery.

Results: Findings from preoperative HOP-MRA plaque imaging of aneurysm walls corresponded well to the intraoperative findings in 15 of 16 aneurysms. In one case complete intraoperative visualization of the aneurysm was impossible due to the local vascular anatomy. Overall sensitivity and specificity of hybrid opposite-contrast MRA were 88.9% and 100%, respectively. During surgery, four aneurysms were classified as grade A, five as grade B, and seven as grade C. The mean ± standard deviation of the contrast ratio for grades A, B, and C was 0.72 ± 0.03, 0.34 ± 0.30, and -0.02 ± 0.09, respectively.

Conclusions: HOP-MRA has high sensitivity for detection of atherosclerotic plaque in the wall of unruptured intracranial aneurysms. There was an excellent correlation between preoperative HOP-MRA grading of atherosclerosis in the aneurysm wall and the intraoperative findings.