Cerebralvascular Disease
Clinical value of high-resolution vessel wall imaging and silent magnetic resonance angiography in re-examination after intracranial aneurysm embolization
Zeng Zhaoxia, Zhang Zhaotao, Tang Xiaoping, Ying Hongxin, Xu Siwei, Gong Lianggeng
Published 2023-01-08
Cite as Chin J Neurol, 2023, 56(1): 39-47. DOI: 10.3760/cma.j.cn113694-20220424-00328
Abstract
ObjectiveTo explore the clinical application of time of flight-magnetic resonance angiography (TOF-MRA), silent magnetic resonance angiography (SilenZ-MRA) and high-resolution vessel wall imaging (HR-VWI) in non-invasive evaluation of intracranial aneurysm after embolization.
MethodsFrom February 2021 to February 2022, 39 patients, including 8 males and 31 females, who were 29-86 (54.50±11.80) years old and had received intracranial aneurysm embolization were collected in the Second Affiliated Hospital of Nanchang University. Kruskal-Wallis test was used to compare the image quality score and the evaluation results of lumen stenosis rate in the stent segments by TOF-MRA, SilenZ-MRA and HR-VWI. The diagnostic value of TOF-MRA, SilenZ-MRA and HR-VWI was analyzed by receiver operating characteristic (ROC) curve with DSA as the reference standard.
ResultsThe image quality scores of TOF-MRA, SilenZ-MRA and HR-VWI were 2(1, 3), 4(3, 4) and 4(4, 4), respectively, with statistically significant difference (H=80.78, P<0.05). The pairwise comparison results were as follows: TOF-MRA vs SilenZ-MRA, P<0.017; TOF-MRA vs HR-VWI, P<0.017; SilenZ-MRA vs HR-VWI, P>0.017. The lumen stenosis rates of stent segments measured by TOF-MRA, SilenZ-MRA, HR-VWI and DSA were 45.00% (29.60%, 61.05%), 17.60% (10.80%, 26.80%), 13.35% (8.90%, 15.95%) and 7.95% (4.80%, 11.25%), respectively, with statistically significant difference (H=67.96, P<0.05). The results of comparison between TOF-MRA, SilenZ-MRA, HR-VWI and DSA were respectively as follows: TOF-MRA vs DSA, P<0.017; SilenZ-MRA vs DSA, P<0.017; HR-VWI vs DSA, P>0.017. DSA review showed that 12 (27.91%,12/43) aneurysms were not completely embolized, and 31 (72.09%, 31/43) aneurysms were completely embolized. The area under the curve of TOF-MRA, SilenZ-MRA and HR-VWI for evaluating the postoperative complete embolization of aneurysm was 0.75, 1.00 and 0.94, respectively, with statistically significant differences between TOF-MRA and HR-VWI (Z=2.53, P<0.05) as well as between TOF-MRA and SilenZ-MRA (Z=3.32, P<0.05).
ConclusionsHR-VWI can clearly display the stent-segment lumen of the parent artery, and evaluate the stent-segment arterial wall and whether the stent-segment lumen is unobstructed or not. SilenZ-MRA is significantly superior to TOF-MRA in the evaluation of postoperative embolization status of aneurysms, and slightly superior to HR-VWI in tumor neck display. Combined application of HR-VWI and SilenZ-MRA has certain clinical significance for non-invasive evaluation of intracranial aneurysm after embolization.
Key words:
Intracranial aneurysm; Magnetic resonance imaging; Magnetic resonance angiography; Angiography, digital subtraction
Contributor Information
Zeng Zhaoxia
Medical Imaging Center, the Second Affiliated Hospital of Nanchang University, Nanchang 330001, China
Zhang Zhaotao
Medical Imaging Center, the Second Affiliated Hospital of Nanchang University, Nanchang 330001, China
Tang Xiaoping
Medical Imaging Center, the Second Affiliated Hospital of Nanchang University, Nanchang 330001, China
Ying Hongxin
Medical Imaging Center, the Second Affiliated Hospital of Nanchang University, Nanchang 330001, China
Xu Siwei
Medical Imaging Center, the Second Affiliated Hospital of Nanchang University, Nanchang 330001, China
Gong Lianggeng
Medical Imaging Center, the Second Affiliated Hospital of Nanchang University, Nanchang 330001, China
