scholarly journals The Role of 3 Tesla MRA in the Detection of Intracranial Aneurysms

2012 ◽  
Vol 2012 ◽  
pp. 1-9 ◽  
Author(s):  
Eftychia Z. Kapsalaki ◽  
Christos D. Rountas ◽  
Kostas N. Fountas
Keyword(s):  
Magnetic Field ◽  
Intracranial Aneurysms ◽  
Flow Characteristics ◽  
Imaging Method ◽  
Digital Subtraction ◽  
Prompt Treatment ◽  
Tof Mra ◽  
Contrast Enhanced ◽  
Erroneous Interpretation

Intracranial aneurysms constitute a common pathological entity, affecting approximately 1–8% of the general population. Their early detection is essential for their prompt treatment. Digital subtraction angiography is considered the imaging method of choice. However, other noninvasive methodologies such as CTA and MRA have been employed in the investigation of patients with suspected aneurysms. MRA is a noninvasive angiographic modality requiring no radiation exposure. However, its sensitivity and diagnostic accuracy were initially inadequate. Several MRA techniques have been developed for overcoming all these drawbacks and for improving its sensitivity. 3D TOF MRA and contrast-enhanced MRA are the most commonly employed techniques. The introduction of 3 T magnetic field further increased MRA's sensitivity, allowing detection of aneurysms smaller than 3 mm. The development of newer MRA techniques may provide valuable information regarding the flow characteristics of an aneurysm. Meticulous knowledge of MRA's limitations and pitfalls is of paramount importance for avoiding any erroneous interpretation of its findings.

Imaging of aortoiliac arterial disease: Duplex ultrasound and MR angiography versus digital subtraction angiography

2000 ◽  
Vol 41 (2) ◽  
pp. 125-132 ◽  
Author(s):  
P. Lundin ◽  
Å. Svensson ◽  
E. Henriksen ◽  
T. Jonason ◽  
C. Forssell ◽  
...  
Keyword(s):  
Digital Subtraction Angiography ◽  
Mr Angiography ◽  
Duplex Ultrasound ◽  
Arterial Disease ◽  
Digital Subtraction ◽  
Vascular Intervention ◽  
Non Invasive ◽  
Tof Mra ◽  
Invasive Test ◽  
Contrast Enhanced

Purpose: To evaluate and compare the diagnostic accuracy of duplex ultrasound (US) and MR angiography (MRA) at 1.0 T in aortoiliac arterial disease using digital subtraction angiography (DSA) as the reference standard. In addition, a comparison of the 2D time-of flight (TOF) and 3D contrast-enhanced MRA (CE MRA) techniques was performed. Material and Methods: Prospectively, 39 patients with symptoms of lower-extremity arterial occlusive disease were examined using US, TOF MRA, CE MRA and DSA. Significant lesions (stenosis ≥50%) and occlusions were evaluated blindly for each method. Results: For all segments, the sensitivity for US, TOF MRA and CE MRA with regard to significant lesions was 0.72, 0.81 and 0.81, respectively, and the specificity for each was 0.97, 0.91 and 0.92, respectively. For significant lesions above the inguinal ligament the corresponding sensitivity was 0.84, 0.89 and 0.94 and the specificity 0.93, 0.82 and 0.73, respectively. The specificity was higher when the two MRA methods were combined. TOF MRA overgraded 7 segments as occluded. In most cases, the length of the occlusions was correctly determined on CE MRA, overestimated on TOF MRA and uncertain on US. Conclusion: Neither US nor MRA were sufficiently accurate to fully replace angiography. MRA was preferable to US as a non-invasive test when vascular intervention was contemplated. Although CE MRA was superior to TOF MRA, the most accurate results were achieved when the two methods were combined.

scholarly journals Comparison of tof mra, contrast-enhanced mra and subtracted cta from ctp in residue evaluation of treated intracranial aneurysms

2017 ◽  
Author(s):  
Tolga Turan Dundar ◽  
Ayse Aralasmak ◽  
Huseyin Ozdemir ◽  
Mehmet Hakan Seyithanoglu ◽  
Omer Uysal ◽  
...  
Keyword(s):  
Intracranial Aneurysms ◽  
Tof Mra ◽  
Contrast Enhanced

Follow-up of intracranial aneurysms treated by flow diverter: comparison of three-dimensional time-of-flight MR angiography (3D-TOF-MRA) and contrast-enhanced MR angiography (CE-MRA) sequences with digital subtraction angiography as the gold standard

2014 ◽  
Vol 8 (1) ◽  
pp. 81-86 ◽  
Author(s):  
Jonathan Attali ◽  
Azzedine Benaissa ◽  
Sébastien Soize ◽  
Krzysztof Kadziolka ◽  
Christophe Portefaix ◽  
...  
Keyword(s):  
Gold Standard ◽  
Mr Angiography ◽  
Three Dimensional ◽  
Flow Diverter ◽  
Parent Artery ◽  
Digital Subtraction ◽  
Tof Mra ◽  
Contrast Enhanced ◽  
Aneurysm Occlusion

Background and purposeFollow-up of intracranial aneurysms treated by flow diverter with MRI is complicated by imaging artifacts produced by these devices. This study compares the diagnostic accuracy of three-dimensional time-of-flight MR angiography (3D-TOF-MRA) and contrast-enhanced MRA (CE-MRA) at 3 T for the evaluation of aneurysm occlusion and parent artery patency after flow diversion treatment, with digital subtraction angiography (DSA) as the gold standard.Materials and methodsPatients treated with flow diverters between January 2009 and January 2013 followed by MRA at 3 T (3D-TOF-MRA and CE-MRA) and DSA within a 48 h period were included in a prospective single-center study. Aneurysm occlusion was assessed with full and simplified Montreal scales and parent artery patency with three-grade and two-grade scales.ResultsTwenty-two patients harboring 23 treated aneurysms were included. Interobserver agreement using simplified scales for occlusion (Montreal) and parent artery patency were higher for DSA (0.88 and 0.61) and CE-MRA (0.74 and 0.55) than for 3D-TOF-MRA (0.51 and 0.02). Intermodality agreement was higher for CE-MRA (0.88 and 0.32) than for 3D-TOF-MRA (0.59 and 0.11). CE-MRA yielded better accuracy than 3D-TOF-MRA for aneurysm remnant detection (sensitivity 83% vs 50%; specificity 100% vs 100%) and for the status of the parent artery (specificity 63% vs 32%; sensitivity 100% vs 100%).ConclusionsAt 3 T, CE-MRA is superior to 3D-TOF-MRA for the evaluation of aneurysm occlusion and parent artery patency after flow diversion treatment. However, intraluminal evaluation remains difficult with MRA regardless of the sequence used.

Assessment of Transcranial Color-coded Duplex Sonography for the Surveillance of Intracranial Aneurysms Treated with Guglielmi Detachable Coils

Neurosurgery ◽  
2003 ◽  
Vol 53 (4) ◽  
pp. 866-872 ◽  
Author(s):  
Carole L. Turner ◽  
J. Nicholas P. Higgins ◽  
Peter J. Kirkpatrick
Keyword(s):  
Contrast Agent ◽  
Contrast Enhancement ◽  
Intracranial Aneurysms ◽  
Duplex Sonography ◽  
Imaging Method ◽  
Residual Flow ◽  
Digital Subtraction ◽  
Guglielmi Detachable Coils ◽  
Detachable Coils ◽  
Color Coded Duplex Sonography

Abstract OBJECTIVE We sought to evaluate the sensitivity and specificity of transcranial color-coded duplex sonography (TCCS) and the effect of an ultrasonographic contrast agent in the long-term surveillance of intracranial aneurysms treated with Guglielmi detachable coils. METHODS Forty-six studies were obtained in patients with intracranial aneurysms treated with coils. All studies were obtained within 2 months of surveillance digital subtraction angiograms, which was adopted as the standard for observing aneurysm refilling. For 34 of the studies, imaging was performed both before and after infusing an ultrasonographic contrast agent (Levovist). The remaining 12 studies were unenhanced. Aneurysms were described either as being fully occluded or as having residual flow. The degree of residual flow was quantified as minor, moderate, or extensive. The operator was blinded to the results of digital subtraction angiography during TCCS assessment. RESULTS TCCS correctly identified 19 of 20 aneurysms with complete occlusion (sensitivity, 95%; specificity, 84%). TCCS also identified all 16 of the clinically relevant aneurysms with either moderate or extensive residual flow visualized on digital subtraction angiograms and 5 aneurysms only after contrast enhancement (sensitivity, 100%; specificity, 97%). The overall accuracy of TCCS in identifying clinically relevant aneurysms was 85% without contrast enhancement and 96% with contrast enhancement. CONCLUSION Contrast-enhanced TCCS shows promise as a noninvasive imaging method for the surveillance of coiled intracranial aneurysms.

scholarly journals The use of contrast-enhanced, time-resolved magnetic resonance angiography in cerebrovascular pathology

2019 ◽  
Vol 47 (6) ◽  
pp. E3 ◽  
Author(s):  
Jonathan A. Grossberg ◽  
Brian M. Howard ◽  
Amit M. Saindane
Keyword(s):  
Magnetic Resonance ◽  
Magnetic Resonance Angiography ◽  
Best Practices ◽  
Imaging Modality ◽  
Digital Subtraction ◽  
Time Resolved ◽  
Contrast Enhanced ◽  
Contrast Allergy

Digital subtraction angiography (DSA) has long been the imaging gold standard in the evaluation, treatment, and follow-up of cerebro- and spinovascular disorders. However, DSA has the disadvantages of invasiveness, contrast allergy or nephropathy, the impracticality of procedural preparation and recovery, and expense. Contrast-enhanced (CE), time-resolved (TR) magnetic resonance angiography (CE TR-MRA) is a sophisticated, relatively novel imaging modality that provides multiphasic contrast-enhanced visualization of the neurovasculature. Given the crucial role of angiography in all aspects of care for patients with complex neurovascular disorders, it is incumbent on those who care for these patients to understand the usefulness and pitfalls of novel imaging in this arena to ensure best practices, and to deliver cutting edge care to these patients in a way that minimizes cost, but does not compromise quality. CE TR-MRA has the potential to play an expanded role in the workup and follow-up across the spectrum of neurovascular disease, and this review is aimed to help neurosurgeons better understand how CE TR-MRA can be used to better manage patients in this cohort.

scholarly journals Contrast-Enhanced and Time-of-Flight MR Angiographic Assessment of Endovascular Coiled Intracranial Aneurysms at 1.5 T

2014 ◽  
Vol 20 (6) ◽  
pp. 686-692 ◽  
Author(s):  
Akin Levent ◽  
Ihsan Yuce ◽  
Suat Eren ◽  
Omer Ozyigit ◽  
Mecit Kantarci
Keyword(s):  
Magnetic Resonance ◽  
Magnetic Resonance Angiography ◽  
Sensitivity And Specificity ◽  
Intracranial Aneurysms ◽  
Interobserver Agreement ◽  
Three Dimensional ◽  
Time Of Flight ◽  
Selective Embolization ◽  
Tof Mra ◽  
Contrast Enhanced

This study evaluated contrast-enhanced magnetic resonance angiography (CE-MRA) and three-dimensional time-of-flight magnetic resonance angiography (3D-TOF-MRA) through comparisons with digital subtraction angiography (DSA) for the follow-up of intracranial aneurysms treated with detachable coils. Sixty-seven patients with 79 aneurysms underwent 3D-TOF-MRA, CE-MRA, and catheter angiography one year after coiling. Two independent observers classified recanalization status on images as neck or body remnant or no recanalization. For 3D-TOF-MRA and CE-MRA, the intermodality agreement, interobserver agreement, and correlation with angiography were assessed. Sixty-seven patients with 79 coiled aneurysms agreed to participate in the study. Three aneurysms could not be detected on 3D-TOF-MRA, so they were excluded from this study. Interobserver agreement was very good for 3D-TOF-MRA and CE-MRA (kappa (κ): 0.87, 0.94, respectively). Correlation of TOF-MRA with angiography was good (κ: 0.76). Correlation of CE-MRA with angiography was excellent (κ: 0.91). The sensitivity and specificity of TOF-MRA were 92% and 98%, respectively. The sensitivity and specificity of CE-MRA were 96% and 98%, respectively. After selective embolization of intracranial aneurysms, CE-MRA is useful and comparable to DSA in the assessment of aneurysmal recanalization. Agreement with the gold standard is stronger with CE-MRA than with 3D-TOF-MRA.

The role of contrast-enhanced MR angiography in the assessment of recently ruptured intracranial aneurysms: a comparative study

2005 ◽  
Vol 47 (10) ◽  
pp. 780-791 ◽  
Author(s):  
Ercument Unlu ◽  
Bilge Cakir ◽  
Burak Gocer ◽  
Nermin Tuncbilek ◽  
Murat Gedikoglu
Keyword(s):  
Comparative Study ◽  
Intracranial Aneurysms ◽  
Mr Angiography ◽  
Contrast Enhanced ◽  
Ruptured Intracranial Aneurysms

scholarly journals Contrast-Enhanced Ultrasonography in the Diagnosis and Treatment Modulation of Breast Cancer

2021 ◽  
Vol 11 (2) ◽  
pp. 81
Author(s):  
Ioana Boca (Bene) ◽  
Sorin M. Dudea ◽  
Anca I. Ciurea
Keyword(s):  
Breast Cancer ◽  
High Performance ◽  
Axillary Staging ◽  
Imaging Method ◽  
Contrast Enhanced Ultrasound ◽  
Contrast Enhanced ◽  
Contrast Enhanced Ultrasonography ◽  
Malignant Lesions

The aim of this paper is to highlight the role of contrast-enhanced ultrasound in breast cancer in terms of diagnosis, staging and follow-up of the post-treatment response. Contrast-enhanced ultrasound (CEUS) is successfully used to diagnose multiple pathologies and has also clinical relevance in breast cancer. CEUS has high accuracy in differentiating benign from malignant lesions by analyzing the enhancement characteristics and calculating the time-intensity curve’s quantitative parameters. It also has a significant role in axillary staging, especially when the lymph nodes are not suspicious on clinical examination and have a normal appearance on gray-scale ultrasound. The most significant clinical impact consists of predicting the response to neoadjuvant chemotherapy, which offers the possibility of adjusting the therapy by dynamically evaluating the patient. CEUS is a high-performance, feasible, non-irradiating, accessible, easy-to-implement imaging method and has proven to be a valuable addition to breast ultrasound.

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