Follow-up of intracranial aneurysms treated with stent-assisted coiling: Comparison of contrast-enhanced MRA, time-of-flight MRA, and digital subtraction angiography

J Neuroradiol. 2017 Feb;44(1):44-51. doi: 10.1016/j.neurad.2016.10.004. Epub 2016 Nov 9.


Background and purpose: Data about non-invasive follow-up of aneurysm after stent-assisted coiling is scarce. We aimed to compare time-of-flight (TOF) magnetic resonance angiography (MRA) (3D-TOF-MRA) and contrast-enhanced MRA (CE-MRA) at 3-Tesla, with digital subtraction angiography (DSA) for evaluating aneurysm occlusion and parent artery patency after stent-assisted coiling.

Materials and methods: In this retrospective single-center study, patients were included if they had an intracranial aneurysm treated by stent-assisted coiling between March 2008 and June 2015, followed with both MRA sequences (3D-TOF-MRA and CE-MRA) at 3-Tesla and DSA, performed in an interval<48hours.

Results: Thirty-five aneurysms were included. Regarding aneurysm occlusion evaluation, agreement with DSA was better for CE-MRA (K=0.53) than 3D-TOF-MRA (K=0.28). Diagnostic accuracies for aneurysm remnant depiction were similar for 3D-TOF-MRA and CE-MRA (P=1). Both 3D-TOF-MRA (K=0.05) and CE-MRA (K=-0.04) were unable to detect pathological vessel compared to DSA, without difference in accuracy (P=0.68). For parent artery occlusion detection, agreement with DSA was substantial for 3D-TOF-MRA (K=0.64) and moderate for CE-MRA (K=0.45), with similar good diagnostic accuracies (P=1).

Conclusion: After stent-assisted coiling treatment, 3D-TOF-MRA and CE-MRA demonstrated good accuracy to detect aneurysm remnant (but tended to overestimation). Although CE-MRA agreement with DSA was better, there was no statistical difference between 3D-TOF-MRA and CE-MRA accuracies. Both MRAs were unable to provide a precise evaluation of in-stent status but could detect parent vessel occlusion.

Keywords: Follow-up; Intracranial aneurysm; MR angiography; Sensitivity and specificity; Stent.

Publication types

  • Comparative Study

MeSH terms

  • Aged
  • Angiography, Digital Subtraction / methods*
  • Contrast Media
  • Embolization, Therapeutic*
  • Female
  • Follow-Up Studies
  • Humans
  • Imaging, Three-Dimensional
  • Intracranial Aneurysm / diagnostic imaging*
  • Intracranial Aneurysm / therapy*
  • Magnetic Resonance Angiography / methods*
  • Male
  • Middle Aged
  • Observer Variation
  • Retrospective Studies
  • Sensitivity and Specificity
  • Stents
  • Treatment Outcome


  • Contrast Media