MR Angiography Versus Digital Subtraction Angiography In The Follow-up Of Coiled Cerebral Aneurysms

The treatment of patients with cerebral aneutysms by detachable coils techniques isbecoming increasingly important.However,several previous studies have also reported thatthere are15%-65%of primary embolization is not completely,14%-34%will haverecanalisation, even1.2%-2.6%of the patients will suffer rebleeding.SO long-term regularfollow-up is necessary to establish the stability of endovascular treatment.Traditonally,because of its high degree of sensitivity,digital subtract angiography is regarded as the goldstandard,for the evaluation of intracranial vascular disease. However, DSA is invasive,time-consuming, under ionizing radiation and require hospitalization with economicburden.With the rapid development of MRA techniques in recent years,its non-invasive,highresolution capability, convenient and relatively inexpensive make it become an optionaltechnology for followed-up. Since June2011to March2012,20consecutive patientstreated with detachable coils underwent1.5T TOF MRA, then compared with DSA. Andafter review of the literature, discuss the valueObjective: To assess the value of MR angiography in the follow-up of coiled cerebralaneurysms.Datas and Methods: Since June2011to March2012,20consecutive patients treatedwith detachable coils underwent1.5T TOF MRA, DSA was the gold standard used forevaluating MRA. The time intervals for two examination is1-3days. In addition to the twocases of patients with headache, the rest had no clinical symptoms.5males and15females.Age24-70years, mean52years old. A total of28aneurysms,21of aneurysm embolization,7not embolization aneurysm. Except two patients for aneurysm recurrence after8years and6years to our hospital, the remaining18patients in the postop-erative3-8months follow-up,mean4.7months.All the patients underwent1.5T3D TOF MRA, Raw data image was transmitted to theworkstation,re-established the cerebral vascular with3D-maximum intensity projection.Then used DSA technique to assess bilateral internal carotid artery and vertebralartery.3D-DSA would be used if nessary.All MRA and DSA images be evaluated by two neurosurgeon indepen-dently.If therewas residual blood flow in coiled aneurysms was our key observation object both in MIP and original images,then compared with DSA images. Finally were statistically analysis andevaluation.Results: All the DSA and MRA images were satisfied,only2patients suffered nauseaand irritability,the rest felt no discomfort.DSA images showed:21coiled aneurysms,9complete occlusion,6residual neck,6residual dome,and no parent artery stenosis.MRAshowed:1、MIP images:10complete occlusion,4residual neck,5residual dome,and2parentartery stenosis.2、original images:9complete occlusion,6residual neck,6residual dome,andno parent artery stenosis.MIP images and original images’ Statistically significant results: Sensit-ivity:75%and100%，Specificity:77.8%and100%，False positive rate22.2%and0%，False negative rate:25%、0%。MIP was analyzed by t test with DSA, t=-0.400，p=0.693（p>0.05）, no statisticallysignificant difference between them.MRA original images entirely consistented with DSA.Conclusion:1、1.5T TOF MRA is an satisfactory non-invasive and inexpensive imagingtechnology,can be used as an important choice in the follow-up of coiled cerebralaneurysms.2、Both MIP images and original images should be taken seriously at the same time toevaluate the postoperative results.