Tilman Schubert, Hakim Shakir Husain, Patrick Thurner, Jawid Madjidyar, Isabelle Barnaure, Marco Piccirelli, Markus Klarhöfer, Michaela Schmidt, Peter Speier, Christoph Forman, Zsolt Kulcsar
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Aneurysm dimensions, configuration, image quality and sizing of endovascular devices were compared between conventional TOF-MRA at 3T and UHR-TOF with 3D-DSA as gold standard. Quantitatively, contrast-to-noise ratios (CNR) were compared between TOF-MRAs.</p><p><strong>Results: </strong>On 3D-DSA, 25 aneurysms in 17 patients were detected. On conventional TOF, 23 aneurysms were detected (sensitivity: 92.6%). On UHR-TOF, 25 aneurysms were detected (sensitivity: 100%). Image quality was not significantly different between TOF and UHR-TOF (p = 0.17). Aneurysm dimension measurements were significantly different between conventional TOF (3.89 mm) and 3D-DSA (4.2 mm, p = 0.08) but not between UHR-TOF (4.12 mm) and 3D-DSA (p = 0.19). Irregularities and small vessels at the aneurysm neck were more frequently correctly depicted on UHR-TOF compared to conventional TOF. Comparison of the planned framing coil diameter and flow-diverter (FD) diameter revealed neither a statistically significant difference between TOF and 3D-DSA (coil p = 0.19, FD p = 0.45) nor between UHR-TOF and 3D-DSA (coil: p = 0.53, FD 0.33). The CNR was significantly higher in conventional TOF (p = 0.009).</p><p><strong>Conclusion: </strong>In this pilot study, ultra-high-resolution TOF-MRA visualized all aneurysms and accurately depicted aneurysm irregularities and vessels at the base of the aneurysm comparably to DSA, outperforming conventional TOF. 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引用次数: 0
摘要
目的:三维飞行时间(TOF)磁共振血管造影(MRA)在3T时对颅内动脉瘤具有很高的敏感性，但在动脉瘤特征方面不如三维数字减影血管造影(3D- dsa)。我们应用超高分辨率(UHR) TOF-MRA与传统TOF-MRA和3D-DSA进行对比，研究其在介入前评估颅内动脉瘤的诊断性能。方法:选取17例颅内未破裂动脉瘤患者作为研究对象。比较3T时常规TOF-MRA与3T时以3D-DSA为金标准的UHR-TOF的动脉瘤尺寸、形态、图像质量和血管内装置的尺寸。定量地比较了tof - mra之间的噪声对比比(CNR)。结果:17例患者3D-DSA检查出25个动脉瘤。常规TOF检测出23个动脉瘤(灵敏度:92.6%)。UHR-TOF检测出25个动脉瘤(灵敏度100%)。TOF与UHR-TOF的图像质量差异无统计学意义(p = 0.17)。动脉瘤尺寸测量值在常规TOF(3.89 mm)和3D-DSA(4.2 mm, p = 0.08)之间有显著差异，但在UHR-TOF(4.12 mm)和3D-DSA (p = 0.19)之间无显著差异。与常规TOF相比，UHR-TOF能更准确地描绘出动脉瘤颈部的不规则和小血管。计划框架线圈直径和分流器(FD)直径的比较显示，TOF和3D-DSA之间(线圈p = 0.19,FD p = 0.45)和UHR-TOF和3D-DSA之间(线圈p = 0.53,FD 0.33)均无统计学差异。常规TOF组CNR显著高于对照组(p = 0.009)。结论:在这项初步研究中，与DSA相比，超高分辨率TOF- mra可以显示所有动脉瘤，并准确描绘动脉瘤不规则性和动脉瘤底部血管，优于传统的TOF。UHR-TOF与压缩传感重建似乎代表了一种非侵入性替代介入前DSA颅内动脉瘤。
Ultra-High-Resolution Time-of-Flight MR-Angiography for the Noninvasive Assessment of Intracranial Aneurysms, Alternative to Preinterventional DSA?
Purpose: The 3D time-of-flight (TOF) magnetic resonance angiography (MRA) at 3T shows high sensitivity for intracranial aneurysms but is inferior to three-dimensional digital subtraction angiography (3D-DSA) regarding aneurysm characteristics. We applied an ultra-high-resolution (UHR) TOF-MRA using compressed sensing reconstruction to investigate the diagnostic performance in preinterventional evaluation of intracranial aneurysms compared to conventional TOF-MRA and 3D-DSA.
Methods: In this study 17 patients with unruptured intracranial aneurysms were included. Aneurysm dimensions, configuration, image quality and sizing of endovascular devices were compared between conventional TOF-MRA at 3T and UHR-TOF with 3D-DSA as gold standard. Quantitatively, contrast-to-noise ratios (CNR) were compared between TOF-MRAs.
Results: On 3D-DSA, 25 aneurysms in 17 patients were detected. On conventional TOF, 23 aneurysms were detected (sensitivity: 92.6%). On UHR-TOF, 25 aneurysms were detected (sensitivity: 100%). Image quality was not significantly different between TOF and UHR-TOF (p = 0.17). Aneurysm dimension measurements were significantly different between conventional TOF (3.89 mm) and 3D-DSA (4.2 mm, p = 0.08) but not between UHR-TOF (4.12 mm) and 3D-DSA (p = 0.19). Irregularities and small vessels at the aneurysm neck were more frequently correctly depicted on UHR-TOF compared to conventional TOF. Comparison of the planned framing coil diameter and flow-diverter (FD) diameter revealed neither a statistically significant difference between TOF and 3D-DSA (coil p = 0.19, FD p = 0.45) nor between UHR-TOF and 3D-DSA (coil: p = 0.53, FD 0.33). The CNR was significantly higher in conventional TOF (p = 0.009).
Conclusion: In this pilot study, ultra-high-resolution TOF-MRA visualized all aneurysms and accurately depicted aneurysm irregularities and vessels at the base of the aneurysm comparably to DSA, outperforming conventional TOF. UHR-TOF with compressed sensing reconstruction seems to represent a non-invasive alternative to pre-interventional DSA for intracranial aneurysms.
期刊介绍：
Clinical Neuroradiology provides current information, original contributions, and reviews in the field of neuroradiology. An interdisciplinary approach is accomplished by diagnostic and therapeutic contributions related to associated subjects.
The international coverage and relevance of the journal is underlined by its being the official journal of the German, Swiss, and Austrian Societies of Neuroradiology.
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