Wall Enhancement of the Intracranial Aneurysms Revealed by Magnetic Resonance Vessel Wall Imaging Using Three-Dimensional Turbo Spin-Echo Sequence With Motion-Sensitized Driven-Equilibrium: A Sign of Ruptured Aneurysm?

Clin Neuroradiol. 2016 Sep;26(3):277-83. doi: 10.1007/s00062-014-0353-z. Epub 2014 Oct 21.

Abstract

Purpose: Wall enhancement of saccular cerebral aneurysms has not been researched sufficiently. Our purpose of this study was to investigate the incidence of aneurysmal wall enhancement by the three-dimensional turbo spin-echo sequence with motion-sensitized driven equilibrium (MSDE-3D-TSE) imaging after gadolinium injection.

Methods: We retrospectively reviewed the pre- and postcontrast MSDE-3D-TSE images of 117 consecutive patients with intracranial aneurysms from September 2011 to July 2013. A total of 61 ruptured and 83 unruptured aneurysms of 61 patients with subarachnoid hemorrhage (SAH) and 56 non-SAH patients were enrolled in this study. We evaluated the wall enhancement of each aneurysm on postcontrast MSDE-3D-TSE images compared with precontrast images. We classified the aneurysmal wall enhancement into three groups as "Strong enhancement," "Faint enhancement," and "No enhancement."

Results: "Strong/Faint enhancement" of the aneurysm was detected in 73.8/24.6 % of the ruptured aneurysms and 4.8/13.3 % of the unruptured aneurysms. "No enhancement" was found in 1.6 % of the ruptured aneurysms and 81.9 % of the unruptured aneurysms.

Conclusions: By magnetic resonance vessel wall imaging using the MSDE-3D-TSE sequence, wall enhancement was frequently observed on ruptured aneurysms. Therefore, aneurysmal wall enhancement may be an indicator of the ruptured condition, which is useful information for managing patients with SAH.

Keywords: Cerebral artery aneurysm; Gadolinium; Magnetic resonance imaging; Vessel wall imaging.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Algorithms
  • Aneurysm, Ruptured / diagnostic imaging*
  • Aneurysm, Ruptured / pathology
  • Cerebral Angiography / methods
  • Cerebral Arteries / diagnostic imaging*
  • Cerebral Arteries / pathology
  • Contrast Media
  • Diagnosis, Differential
  • Female
  • Gadolinium
  • Humans
  • Image Enhancement / methods*
  • Image Interpretation, Computer-Assisted / methods
  • Imaging, Three-Dimensional / methods*
  • Intracranial Aneurysm / diagnostic imaging*
  • Intracranial Aneurysm / pathology
  • Magnetic Resonance Angiography / methods*
  • Male
  • Middle Aged
  • Reproducibility of Results
  • Sensitivity and Specificity

Substances

  • Contrast Media
  • Gadolinium