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67th Annual Meeting of the German Society of Neurosurgery (DGNC)
Joint Meeting with the Korean Neurosurgical Society (KNS)

German Society of Neurosurgery (DGNC)

12 - 15 June 2016, Frankfurt am Main

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Implant-specific follow-up imaging of treated intracranial aneurysms: TOF-MRA vs. metal artifact reduced intravenous flatpanel detector (FP) CTA

Meeting Abstract

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  • Nicholas H. Hänsel - Department of Diagnostic and Interventional Neuroradiology, University Hospital RWTH Aachen, Aachen, Germany
  • Rastislav Pjontek - Department of Diagnostic and Interventional Neuroradiology, University Hospital RWTH Aachen, Aachen, Germany
  • Gerrit A. Schubert - Department of Neurosurgery, University Hospital RWTH Aachen, Aachen, Germany
  • Bernhard Scholz - Siemens AG, Healthcare, Imaging & Therapy Division, Forchheim, Germany
  • Yiannis Kyriakou - Siemens AG, Healthcare, Imaging & Therapy Division, Forchheim, Germany
  • Marc A. Brockmann - Department of Diagnostic and Interventional Neuroradiology, University Hospital RWTH Aachen, Aachen, Germany

Deutsche Gesellschaft für Neurochirurgie. 67. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), 1. Joint Meeting mit der Koreanischen Gesellschaft für Neurochirurgie (KNS). Frankfurt am Main, 12.-15.06.2016. Düsseldorf: German Medical Science GMS Publishing House; 2016. DocMI.22.01

doi: 10.3205/16dgnc370, urn:nbn:de:0183-16dgnc3706

Published: June 8, 2016

© 2016 Hänsel et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.

Outline

Text

Objective: Platinum coils and clips impair the image quality in CTA and MRA. Metal artifact reduction (MAR) reduces hardening artifacts in FP-CTA datasets. The aim was to compare the diagnostic quality of TOF-MRA and MAR-FP-CTA and to determine the imaging modality best suited for evaluation of endovascularly and surgically treated aneurysms.

Method: The image quality of MRA and MAR-FP-CTA of 25 patients with intracranial implants (coiling: n=20; clipping: n=15; stent-assisted coiling: n=9) was evaluated by two independent readers. MAR-FP-CTA using a Dyna-CT protocol (20 sec scan time, 496 projections, intravenous contrast material; Artis Zee, Siemens, Forchheim) was compared with MRA-images (1.5 or 3.0 T MR scanner). Nominal data were analyzed using McNemar's Chi-Square test and ordinal variables using the Wilcoxon rank test.

Results: To detect potential residual aneurysms and to evaluate the parent vessel, MAR-FP-CTA was significantly better suited for clipped aneurysms (p <0.01). In patients with larger coil packages (>160 mm3) TOF-MRA allowed for better assessability when compared to MAR-FP-CTA (P <0.01). In patients with small coil packages (<160 mm3) there was no significant difference between TOF-MRA and MAR-FP-CTA. For different clip sizes no significant difference regarding the assessability of images were found. The interobserver comparison showed a high correlation.

Conclusions: For follow-up imaging of clipped aneurysms MAR-FP-CTA is better suited than TOF-MRA. For small (<160 mm3) coil packages there was no significant difference regarding the assessability using MAR-FP-CTA and TOF-MRA. For large (>160 mm3) coil packages, however, TOF-MRA was significantly better suited than MAR-FP-CTA.