Time-resolved magnetic resonance angiography as a follow-up method for visceral artery aneurysm treated with coil-embolisation

Abstract

PurposeThe purpose of this study is to assess the feasibility and usefulness of time-resolved magnetic resonance angiography (TR-MRA) for follow-up of visceral artery aneurysms (VAAs) after embolotherapy.Material and methodsTwenty-one VAAs (11 splenic, six renal, three internal iliac, and one superior pancreaticoduodenal artery aneurysms) in 18 patients (median age, 64 years; range, 36-88 years) previously treated by embolisation with platinum coils, were evaluated. The mean size of the aneurysm was 10.5 cm3 (range, 0.3-132 cm3). Among them, 19 lesions were treated by aneurysmal packing with or without distal-to-proximal embolisation. For the remaining two lesions, distal-to-proximal embolization alone was performed. The mean observation period after embolotherapy was 35 weeks (range, 4-216). All patients underwent TR-MRA following an intravenous bolus injection of gadolinium chelate. Recanalisation was diagnosed when any portion of the aneurysmal sac was enhanced in the arterial phase.ResultsOn TR-MRA, two lesions were diagnosed as recanalised. They were confirmed by transcatheter arteriography and re-treated by embolotherapy. For the remaining 19 lesions, there were no findings of recanalisation on TR-MRA.ConclusionsTR-MRA appears to be a feasible method for follow-up examination of VAAs treated by embolotherapy.

A Case of Successful Hybrid Treatment of Dual Arterial Bypass Using Indocyanine Green Fluorescence Angiography and Endovascular Treatment for Recurrent Superior Mesenteric Artery Aneurysm

“…Alternatively, TR-MRA is a viable method for evaluating SMA aneurysms previously treated with embolotherapy. 7) Recently, attempts to measure and quantitatively evaluate the fluorescence brightness of ICG have been reported. 8) The limitation of this case is that we need further validation and clinical practice to establish the usefulness of ICG angiography for SMA aneurysm treatment, and the possibility of recurrence of dilatation cannot be denied in the future; thus, long-term follow-up is required.…”

Ultra-short Echo-time MR Angiography Combined with a Modified Signal Targeting Alternating Radio Frequency with Asymmetric Inversion Slabs Technique to Assess Visceral Artery Aneurysm after Coil Embolization

“…[1][2][3]5 Generally, the temporal resolutions of DSA and TR-CEMRA in the body trunk regions are approximately 200 ms and 2000-3000 ms, respectively. 10 Given that UTE-mASTAR MRA has a much higher temporal resolution than that of TR-CEMRA, which is comparable to DSA, this method is superior to TR-CEMRA in detecting the hemodynamic status of embolized lesions. Furthermore, UTE-mASTAR MRA directly delineated the continuity of the parent artery adjacent to the coils, which is difficult with TR-CEMRA.…”

“… 2 , 6 , 8 , 9 More recently, the utility of time-resolved contrast-enhanced MRA (TR-CEMRA) has also been reported, which can provide hemodynamic information, for follow-up assessment after embolization. 10 However, some limitations are associated with the use of iodine- or gadolinium-based contrast media, such as the increased risk of adverse reactions in patients with a history of allergies or renal insufficiency.…”

Visceral Artery Aneurysms Embolization and Other Interventional Options: State of the Art and New Perspectives

“…Time-Resolved MRA has been reported as a valuable option for non-invasive follow-up of VAAs after coil embolization. The main advantages of MRA compared to CTA are less susceptibility to metallic artifacts from platinum coils and the ability to detect blood flow with a high temporal resolution [ 36 , 37 ]. Metallic and bowel artifacts also make post embolization assessment difficult with CDUS or contrast-enhanced ultrasonography (CEUS).…”