BACKGROUND AND PURPOSE: The objective of this study was to evaluate the
results of 2D and 3D Fourier-transform, time-of-flight MR angiography and conventional
intraarterial digital subtraction angiography (DSA) in the identification of intracranial
aneurysms and evaluating both techniques in characterization of the aneurysms for
management plans.
MATERAIL AND METHODS: Twenty one patients (10 males and I I females their age
ranged between 14 to 72 years, with mean age 45 years) with subarachnoid hemorrhage
and other neurological deficits underwent MR angiography performed on a standard I -T
superconducting whole-body MR system using multislab, two-dimensional and threedimensional,
time-of-flight sequence. Maximum intensity projection (MIP) was used for
the image analysis, and a multiplanar reconstruction technique was used for all patients.
Digital subtraction angiography (DSA) studies were performed through transfemoral
artery catheterization. Anteroposterior, lateral and periorbital views were obtained, with
additional views acquired when necessary, to identify the parent vessel and aneurysm
neck more clearly.
RESULTS: The conventional DSA detected 24 aneurysms, while only 20 aneurysms
were correctly detected at MR angiography and correlated with that of conventional
angiographic findings. A single aneurysm was detected in 19 patients; while two female
patients had additional aneurysms. The overall sensitivity of MRA in detection of
cerebral aneurysms was about 83%, reaching up to 94% in the detection of aneurysms
more than 5 mm diameter and well correlated with the findings at conventional
angiography. The sensitivity of MRA was poor in the detection of small sized aneurysms
(less than 5 mm), as it was 38 %, while it was high in the detection of medium sized
aneurysms (ranged between 5 to 12 mm), as it was 89 %. The sensitivity was 100% in the
detection of large sized aneurysms (more than 12 mm diameters).
CONCLUSION: Maximum intensity projection (MIP) views obtained with the 2D and
3D Fourier-transform, time-of-flight MR angiography technique proved -in most casesto
be accurate for the identification of aneurysms 5 mm or larger in diameter. However,
MRA it was currently inferior to IA-DSA for the identification of smaller aneurysms and
can miss small lesions (<3 mm). MRA and DAS should be regarded as complementary in
the investigation of patients with subarachnoid hemorrhage.
Accepted; 13/8/2003
Published; 1/9/2003
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