Evaluation of Intra-Aneurysmal Residual Blood Flow with the iMSDE T1-Black Blood Imaging after Flow Diverter Treatment

  • Suzuki Yume
    Department of Neurosurgery, Mie University Graduate School of Medicine, Tsu, Mie, Japan
  • Toma Naoki
    Department of Neurosurgery, Mie University Graduate School of Medicine, Tsu, Mie, Japan
  • Inoue Katsuhiro
    Department of Radiology, Mie University Hospital, Tsu, Mie, Japan
  • Ichikawa Tomonori
    Department of Neurosurgery, Mie University Graduate School of Medicine, Tsu, Mie, Japan
  • Nishikawa Hirofumi
    Department of Neurosurgery, Mie University Graduate School of Medicine, Tsu, Mie, Japan
  • Miura Yoichi
    Department of Neurosurgery, Mie University Graduate School of Medicine, Tsu, Mie, Japan
  • Fujimoto Masashi
    Department of Neurosurgery, Mie University Graduate School of Medicine, Tsu, Mie, Japan
  • Yasuda Ryuta
    Department of Neurosurgery, Mie University Graduate School of Medicine, Tsu, Mie, Japan
  • Maeda Masayuki
    Department of Neuroradiology, Mie University Graduate School of Medicine, Tsu, Mie, Japan
  • Suzuki Hidenori
    Department of Neurosurgery, Mie University Graduate School of Medicine, Tsu, Mie, Japan

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抄録

<p>Objective: We aimed to evaluate the efficacy of the “improved motion-sensitized driven-equilibrium (iMSDE)”-prepared T1-weighted black blood (T1-BB) MRI for monitoring treatment effect with a flow diverter (FD) for cerebral aneurysms.</p><p>Methods: Following the exclusion of concomitant coiling and retreatment cases from 60 consecutive cases of cerebral aneurysms treated with FDs at our institution, 32 with imaging data were included in the analysis. Detectability of residual blood flow within the aneurysms was validated as follows: 1) comparison of MRI sequences (iMSDE-prepared T1-BB images, T1-weighted images [ T1WI], and time-of-flight [ TOF]-MRA) in cases of incompletely occluded aneurysms and 2) comparison of angiography and MRI sequences in the same period.</p><p>Results: 1) The probability of diagnosing intra-aneurysmal blood flow was significantly higher with iMSDE-prepared T1-BB (iMSDE-prepared T1-BB vs. T1WI, p <0.001; iMSDE-prepared T1-BB vs. TOF-MRA, p <0.001). 2) The diagnostic accuracy of residual aneurysmal blood flow was significantly higher with iMSDE-prepared T1-BB than that with T1WI (p = 0.032). Furthermore, in cases of incomplete occlusion, the probability of detecting intra-aneurysmal blood flow was significantly higher with iMSDE-prepared T1-BB (iMSDE-prepared T1-BB vs. T1WI, p <0.001; iMSDE-prepared T1-BB vs. TOF-MRA, p = 0.023).</p><p>Conclusion: Our results demonstrated that iMSDE-prepared T1-BB could help distinguish between blood flow and thrombus within the aneurysms after FD treatment, especially in the early stages of FD treatment.</p>

収録刊行物

  • 脳神経血管内治療

    脳神経血管内治療 17 (8), 159-166, 2023

    特定非営利活動法人 日本脳神経血管内治療学会

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