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J Magn Reson Imaging. 2019 Jul;50(1):193-200. doi: 10.1002/jmri.26553. Epub 2018 Nov 3.

Visualizing wall enhancement over time in unruptured intracranial aneurysms using 3D vessel wall imaging.

Author information

1
Department of Radiology and Biomedical Imaging, University of California, San Francisco, California, USA.
2
Department of Radiology, Changhai Hospital of Shanghai, Shanghai, P.R. China.
3
Department of Neurology, University of California, San Francisco, California, USA.
4
Siemens Healthcare, Erlangen, Germany.

Abstract

BACKGROUND:

Few studies directed at assessing the visualization of the walls of unruptured aneurysms have used higher-resolution 3D MRI vessel wall imaging. Prospective longitudinal studies are also needed to screen vessel wall changes in unruptured aneurysms.

PURPOSE:

To compare the aneurysm wall visualization on pre- and post-3D isotropic T1 -weighted Sampling Perfection with Application-optimized Contrasts by using different flip angle Evolutions (SPACE) images and to explore whether there is a change in wall enhancement at follow up.

STUDY TYPE:

Prospective.

POPULATION:

Twenty-nine patients with a total of 35 unruptured intracranial aneurysms.

SEQUENCE:

3D T1 -weighted pre- and postcontrast SPACE (0.5 mm isotropic) at 3.0T.

ASSESSMENT:

The aneurysm wall visibility (0-5 scale) between pre- and postcontrast images as well as the wall enhancement (0-5 scale) between follow-up and baseline studies (6-30 months, average 12.7 months) were compared. Differences in wall visibility and enhancement were also investigated as a function of aneurysm diameter and location.

STATISTICAL TEST:

The Wilcoxon signed rank paired test was used to compare the wall visibility score between pre- and postcontrast SPACE images, as well as wall enhancement between follow-up and baseline. The Mann-Whitney and Kruskal-Wallis tests were used to investigate the enhancement difference between different diameters and locations.

RESULTS:

Postcontrast images had significantly higher wall visibility (P = 0.01). A wall enhancement score ≥2 was found in 71% of the aneurysms. Changes in levels of wall enhancement were found in 17% of the aneurysms at follow-up studies, but those changes were small. Wall visibility and enhancement scores of large aneurysms were significantly higher than small ones (P < 0.001).

DATA CONCLUSION:

3D T1 -weighted higher resolution SPACE can be used to assess changes in enhancement at follow-up studies. Contrast SPACE image provides better aneurysm wall visibility and improves visualization of the aneurysm wall.

LEVEL OF EVIDENCE:

2 Technical Efficacy: Stage 3 J. Magn. Reson. Imaging 2019;50:193-200.

PMID:
30390363
DOI:
10.1002/jmri.26553

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