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KMID : 0378020060490090027
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New Medical Journal
2006 Volume.49 No. 9 p.27 ~ p.35
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Evaluation of Magnetic Resonance Angiography in Diagnosis of Ruptured Intracerebral Aneurysms
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Kang Dong-Soo
Hong Hyun-Jong
Kong Min-Ho
Song Kwan-Young
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Abstract
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Objective: To determine the efficacy of magnetic resonance angiography (MRA) for the diagnosis of ruptured intracerebral aneurysms in acute subarachnoid hemorrhage and to know limitation to detect small or very small aneurysms, we compared MRA with intraarterial digital subtraction angiography (DSA).
Methods : 60 patients with acute subarachnoid hemorrhage were studied with MRA immediately before intra-arterial DSA. 66 aneurysms were found. 1.5 Tesla 3D-time of flight (TOF) MRA and DSA were performed. MRA and DSA were interpreted by one neuroradiologist for presence, location, size, and morphology of the aneurysms. If aneurysms were demonstrated, early surgery was undertaken including clipping of aneurysmal neck(65cases), GDC embolization (1 case).
Results: Of the 66 aneurysms examined, 11 aneurysms were not detected with MRA. We found the sensitivity of MRA for the detection of aneurysms to be 83.3% and the specificity to be 100%. The main causes of undetected aneurysms with MRA were suspected, not certained aneurysms and small aneurysms less than 3 mm. The detection rate of aneurysms 3 mm or smaller was 68.0%, 4~6 mm 90.3%, larger than 7 mm 100%. In confirming aneurysmal neck, MRA was successful in detecting 65.5% (36/55) and DSA in 81.8% (54/66).
Conclusion: There are limitations in the ability of MRA to detect small or very small aneurysms and it is inadequate to detect morphology of aneurysm, but MRA offers valuable and reliable information on ruptured aneurysms in acute subarachnoid hemorrhage, allowing the optimization of projection angles at DSA.
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KEYWORD
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Intracerebral aneurysm, MRA, DSA
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