Usefulness of non-contrast-enhanced ultrashort echo time magnetic resonance angiography for assessing cerebral aneurysms after woven endobridge device treatment

IF 2 4区医学 Q3 NEUROSCIENCES

Journal of Stroke & Cerebrovascular Diseases Pub Date : 2025-05-27 DOI:10.1016/j.jstrokecerebrovasdis.2025.108361

Yasuhiko Nariai , Tomoji Takigawa , Kazuma Sasaki , Akio Hyodo , Kensuke Suzuki

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引用次数: 0

Abstract

Background and objectives

Digital subtraction angiography (DSA) is the gold standard follow-up modality for assessing aneurysm occlusion state after Woven EndoBridge (WEB; MicroVention/Terumo, Aliso Viejo, CA, USA) treatment. However, because of the invasiveness of DSA, time-of-flight (TOF) magnetic resonance angiography (MRA) is also used, although it has limited diagnostic accuracy: signal loss in MRA due to the WEB device hinders clear assessment of aneurysm remnants post-treatment. This study aimed to determine whether the non-contrast-enhanced (non-CE) ultrashort echo time (UTE)-MRA sequence, with its ability to reduce metal-induced susceptibility artifacts in MRA, is a reliable follow-up modality to assess aneurysm occlusion status after WEB device treatment.

Materials and methods

From June 2024 to February 2025 at our institution, 12 consecutive patients with 14 aneurysms underwent TOF-MRA, UTE-MRA, and DSA for occlusion assessment 6 months after WEB treatment. Angiographic assessments were independently performed by two observers using the WEB Occlusion Scale (WOS). Visibility of the parent vessel at the WEB placement site in TOF-MRA and UTE-MRA was also evaluated.

Results

According to DSA, the rates of WOS grade A/B (complete occlusion), C, and D aneurysms were 64.3 %, 28.6 %, and 7.1 %, respectively. Regarding intermodality agreement between TOF-MRA and DSA, the κ coefficient was 0.19, indicative of poor agreement. Intermodality agreement between UTE-MRA and DSA was excellent (κ = 0.88). The parent vessel adjacent to the WEB device tended to be visible more often with UTE-MRA (85.7 %) than with TOF-MRA (50.0 %) (p = 0.10).

Conclusions

Non-CE UTE-MRA may be a reliable and less invasive imaging modality after WEB treatment.

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非对比增强超短回波时间磁共振血管造影对编织桥内装置治疗后脑动脉瘤的评估价值

背景与目的数字减影血管造影（DSA）是评估编织桥术后动脉瘤闭塞状态的金标准随访方式。MicroVention/Terumo, Aliso Viejo， CA， USA)治疗。然而，由于DSA的侵入性，飞行时间（TOF）磁共振血管造影（MRA）也被使用，尽管它的诊断准确性有限：由于WEB设备导致MRA信号丢失，阻碍了对治疗后动脉瘤残余的清晰评估。本研究旨在确定非对比增强（非ce）超短回波时间(UTE)-MRA序列是否能够减少MRA中金属诱导的易感性伪影，是评估WEB设备治疗后动脉瘤闭塞状态的可靠随访方式。材料与方法我院于2024年6月至2025年2月，连续12例14个动脉瘤患者在治疗6个月后分别行TOF-MRA、UTE-MRA和DSA进行闭塞性评估。血管造影评估由两名观察员使用WEB闭塞量表（WOS）独立进行。在TOF-MRA和UTE-MRA中还评估了母血管在放置位置的可见性。结果经DSA检查，WOS A/B级（完全闭塞）动脉瘤发生率为64.3%，C级为28.6%，D级为7.1%。TOF-MRA与DSA之间的多模态一致性，κ系数为0.19，表明一致性较差。UTE-MRA与DSA之间的模态一致性极好（κ = 0.88）。UTE-MRA（85.7%）比TOF-MRA（50.0%）更容易看到靠近WEB装置的母血管（p = 0.10）。结论非ce UTE-MRA是一种可靠的微创成像方式。

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来源期刊

Journal of Stroke & Cerebrovascular Diseases Medicine-Surgery

CiteScore

5.00

自引率

4.00%

发文量

583

审稿时长

62 days

期刊介绍： The Journal of Stroke & Cerebrovascular Diseases publishes original papers on basic and clinical science related to the fields of stroke and cerebrovascular diseases. The Journal also features review articles, controversies, methods and technical notes, selected case reports and other original articles of special nature. Its editorial mission is to focus on prevention and repair of cerebrovascular disease. Clinical papers emphasize medical and surgical aspects of stroke, clinical trials and design, epidemiology, stroke care delivery systems and outcomes, imaging sciences and rehabilitation of stroke. The Journal will be of special interest to specialists involved in caring for patients with cerebrovascular disease, including neurologists, neurosurgeons and cardiologists.