Intracranial aneurysms: diagnostic accuracy of MR angiography with evaluation of maximum intensity projection and source images.

Korogi, Yukunori; Takahashi, Manabu; Mabuchi, Nobuhisa; Nakagawa, Toshio; Fujiwara, Satoru; Horikawa, Yo; Miki, Hitoshi; O’uchi, Toshihiro; Shiga, Hayao; Shiokawa, Yoshiaki; Watabe, T; Furuse, Masahiro

doi:10.1148/radiology.199.1.8633146

Cited by 68 publications

(29 citation statements)

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“…The overall frequency in the general population ranges from 0.2% to 9% (mean frequency, about 5%) in autopsy studies 7,8) . However, the likelihood of detection of unruptured aneurysms has increased with improved imaging techniques, such as 3D computed tomography angiography and magnetic resonance angiography 6,11,12) . The effect of rupture of an intracranial aneurysms are devastating, and surgical morbidity and mortality remain as high as 60% 16) despite recent advances in the intensive management of patients with subarachnoid hemorrhage (SAH) 5) .…”

Section: Introductionmentioning

confidence: 99%

What Is the Significance of a Large Number of Ruptured Aneurysms Smaller than 7 mm in Diameter?

Joo

Lee

Noh

et al. 2009

J Korean Neurosurg Soc

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Objective : The International Study of Unruptured Intracranial Aneurysms (ISUIA) reported that the 5-year cumulative rupture rate of small unruptured aneurysms less than 7 mm in diameter is very low depending on the aneurysm's location. However, we have seen a large number of ruptured aneurysms less than 7 mm in clinical practice. The purpose of this study was to review our experience and to measure the size and location at which aneurysms ruptured in our patient population. Methods : We reviewed the characteristics of aneurysms, such as size and location, from the original angiograms of patients who were admitted to our hospital between January 2004 and December 2007. All aneurysms were treated surgically or through endovascular procedures. Results : Interventional or surgical treatment was given to a total of 889 patients, including 568 females and 321 males. At the time of our study, 627 cases were ruptured aneurysms and 262 cases were unruptured aneurysms. Of the ruptured cases, the mean diameter of the aneurysm was 6.28 mm. We found that 71.8% of ruptured aneurysms were smaller than 7 mm in diameter, and 87.9%, were smaller than 10 mm. Based on location, the data show that anterior communicating artery aneurysms most often presented with rupture sizes less than 7 mm (76.8%) and 10 mm (92.1%) in diameter. Most ruptured aneurysms were less than 7 mm in size, although recent studies have noted that small aneurysms are less likely to rupture. Conclusion : Although the natural history of unruptured intracranial aneurysms remains controversial, the aneurysm size and location play a signigicant role in determining the risk of rupture. Larger sample sizes and a long term study are needed to reveal the natural history and the rupture risk of unruptured intracranial aneurysms because the size of most ruptured aneurysms was less than 7 mm in diameter in our series.

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Section: Introductionmentioning

confidence: 99%

What Is the Significance of a Large Number of Ruptured Aneurysms Smaller than 7 mm in Diameter?

Joo

Lee

Noh

et al. 2009

J Korean Neurosurg Soc

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“…2,5,6 Despite the continuing sophistication of the imaging technique, 1 important cause of the limited sensitivity of MRA is the detection failures of radiologists. Interpretation of both source and reconstructed images is recommended to achieve good sensitivity of MRA, [7][8][9] but detecting relatively small lesions is a timeconsuming and difficult task.…”

mentioning

confidence: 99%

Computer-Assisted Detection of Cerebral Aneurysms in MR Angiography in a Routine Image-Reading Environment: Effects on Diagnosis by Radiologists

Miki¹,

Hayashi²,

Masutani

et al. 2016

AJNR Am J Neuroradiol

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“…Vernooij and colleagues found an incidence of 1.8% in 2000 scanned people, which is equal to the prevalence estimated from the ISUIA study [Vernooij et al 2007;International Study of Unruptured Intracranial Aneurysms Investigators, 1998]. MRA sensitivity is estimated to be as high as >95% for aneurysms >6 mm, with rapidly decreasing sensitivity for the reduction of aneurysmal size (60% sensitivity for aneurysms <5 mm) [Atlas et al 1997;Korogi et al 1996]. Local resolution of tomographic imaging techniques does not grant assured detection of aneurysms smaller than 3 mm in size [Forsting, 2005].…”

Section: Discussionmentioning

confidence: 96%

Intracranial aneurysms: optimized diagnostic tools call for thorough interdisciplinary treatment strategies

Mueller

Schlamann

Mueller

et al. 2011

Ther Adv Neurol Disord

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Abstract:Objective: Intracranial aneurysms (IAs) require deliberately selected treatment strategies as they are incrementally found prior to rupture and deleterious subarachnoid haemorrhage (SAH). Multiple and recurrent aneurysms necessitate both neurointerventionalists and neurosurgeons to optimize aneurysmal occlusion in an interdisciplinary effort. The present study was conducted to condense essential strategies from a single neurovascular centre with regard to the lessons learned. Method: Medical charts of 321 consecutive patients treated for IAs at our centre from September 2008 until December 2010 were retrospectively analysed for clinical presentation of the aneurysms, multiplicity and treatment pathways. In addition, a selective Medline search was performed. Results: A total of 321 patients with 492 aneurysms underwent occlusion of their symptomatic aneurysm: 132 (41.1%) individuals were treated surgically, 189 (58.2%) interventionally; 138 patients presented with a SAH, of these 44.2% were clipped and 55.8% were coiled. Aneurysms of the middle cerebral artery were primarily occluded surgically (88), whereas most of the aneurysms of the internal carotid artery and anterior communicating artery (114) were treated endovascularly. Multiple aneurysms (range 25 aneurysms/individual) were diagnosed in 98 patients (30.2%). During the study period 12 patients with recurrent aneurysms were allocated to another treatment modality (previously clip to coil and vice versa). Conclusions: Our data show that successful interdisciplinary occlusion of IAs is based on both neurosurgical and neurointerventional therapy. In particular, multiple and recurrent aneurysms require tailored individual approaches to aneurysmal occlusion. This is achieved by a consequent interdisciplinary pondering of the optimal strategy to occlude IAs in order to prevent SAH.

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Intracranial aneurysms: diagnostic accuracy of MR angiography with evaluation of maximum intensity projection and source images.

Abstract: Sensitivity may improve with combined reading of nonselective MIP and source images.

Cited by 68 publications

References 0 publications

What Is the Significance of a Large Number of Ruptured Aneurysms Smaller than 7 mm in Diameter?

What Is the Significance of a Large Number of Ruptured Aneurysms Smaller than 7 mm in Diameter?

Computer-Assisted Detection of Cerebral Aneurysms in MR Angiography in a Routine Image-Reading Environment: Effects on Diagnosis by Radiologists

Intracranial aneurysms: optimized diagnostic tools call for thorough interdisciplinary treatment strategies

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