Article
Aneurysm wall enhancement in black-blood magnetic resonance angiography
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Authors
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Bixia Chen
- Universitätsklinikum Essen, Klinik für Neurochirurgie, Essen, Deutschland
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Philipp Dammann
- Universitätsklinikum Essen, Klinik für Neurochirurgie, Essen, Deutschland
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Ramazan Jabbarli
- Universitätsklinikum Essen, Klinik für Neurochirurgie, Essen, Deutschland
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Christoph Mönninghoff
- Universitätsklinikum Essen, Institut für Diagnostische und Interventionelle Radiologie und Neuroradiologie, Essen, Deutschland
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Isabel Wanke
- Universitätsklinikum Essen, Institut für Diagnostische und Interventionelle Radiologie und Neuroradiologie, Essen, Deutschland; Klinik Hirslanden Zürich, Radiologie, Zürich, Deutschland
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Ulrich Sure
- Universitätsklinikum Essen, Klinik für Neurochirurgie, Essen, Deutschland
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Karsten H. Wrede
- Universitätsklinikum Essen, Klinik für Neurochirurgie, Essen, Deutschland
| Published: | June 18, 2018 |
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Outline
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Objective: Black-blood (BB) magnetic resonance angiography (MRA) has recently been reported as a practical tool for aneurysm wall imaging. Several reports have suggested that aneurysm instability is directly related to aneurysm wall enhancement (AWE) in BB MRA. This study analyses the frequency and quantity of AWE in a single center cohort.
Methods: Imaging Data of aneurysm patients, who underwent BB MRA at 1.5 Tesla or 3.0 Tesla from June 2015 until October 2017 was analyzed. The study was conducted according to the principles expressed in the Declaration of Helsinki and was approved by the local university institutional review board. In all patients BB sequences were acquired before and after injection of the contrast agent. Two neurosurgeons and a neuroradiologist evaluated aneurysm location, size and AWE in consensus reading. Correlation between aneurysm size [mm] and presence of AWE was determined by calculating the area under the curve (AUC) of the receiver operating characteristic (ROC) curve.
Results: Black-blood MRA sequences of 35 patients with a total of 44 intracranial aneurysm were evaluated. Aneurysm locations included middle cerebral artery (n=13), internal carotid artery (n=11), anterior communicating artery (n=5), basilar artery (n=4), vertebral artery (n=4), anterior cerebral artery (n=3), superior cerebellar artery (n=2), posterior cerebral artery (n=1) and pericallosal artery (n=1). Forty-one aneurysms were innocent, three aneurysms were ruptured. Mean aneurysm size was 7.9mm (range: 2-27mm). Twenty-one aneurysms (19 innocent, 2 ruptured) showed AWE including all aneurysms with a size of 8mm or larger (n=15). The AUC of the ROC curve of AWE and aneurysm size correlation was excellent with 0.95. Figure 1 shows a right middle cerebral artery aneurysm in a 51-year-old male patient before (A) and after (B) injection of contrast agent in Black-blood MRA. The 9mm aneurysm shows focal pathological wall enhancement in the anterior wall portion (asterisk).
Conclusion: Aneurysm wall enhancement in black-blood MRA correlates with aneurysm size. Two out of three ruptured aneurysms showed wall enhancement. Aneurysm wall enhancement in BB MRA is a potential marker for in-vivo assessment of aneurysm stability warranting further prospective evaluation and correlation with aneurysm wall immunohistochemistry.
Figure 1 [Fig. 1]
