Abstract P194: Comparison Study between Three-dimensional Time-of-Flight Magnetic Resonance Angiography and Rotational Digital Subtraction Angiography in Detection of Intracranial Aneurysms
Background and Purpose We prospectively evaluate the effectiveness of unenhanced, three-dimensional time-of-flight magnetic resonance angiography (3D-TOF-MRA) with volume rendering (VR) at 3-T in the detection of intracranial aneurysms and to compare the results with those of rotational digital subtraction angiography (RDSA) and VR-DSA.
Methods 138 consecutive patients with suspected or known aneurysms and other cerebral vascular diseases detected by MRA underwent DSA examination. Post-processing techniques, including maximum intensity projection (MIP), VR, the single artery highlighting method, appropriate threshold of the window width and level and MR source images was performed by the 3D specialist. VR-DSA was obtained from the RDSA data as the gold standard. Three blinded readers evaluated the diagnostic sensitivity and accuracy.
Results The RDSA and VR-DSA revealed 146 aneurysms in 122 patients and no aneurysms in 16 patients. Of 276 vessels with RDSA and VR-DSA, 136 vessels had 146 aneurysms and 140 vessels had none. Per vessel and per aneurysm sensitivities for all readers were 100%, while the per vessel accuracy ranged 97.5–98.6% and the per aneurysm accuracy ranged 95.1–97.0%. Accuracy was slightly lower for small aneurysms (<3 mm) and for those located at the internal carotid artery, but no significant differences were noted between small and large aneurysms or among aneurysms detected at different locations. No false-negatives and 8 false-positives were observed.
Conclusions The effectiveness of VR 3D-TOF-MRA at 3T as an alternative to catheter cerebral angiography for the evaluation of intracranial aneurysms was validated by its excellent sensitivity, accuracy, and correlation with VR-DSA.