Published Online
on March 9, 2006

A more recent version of this article appeared on April 1, 2006

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Submitted on December 16, 2005
Accepted on January 25, 2006

Intracranial Aneurysms Treated With Guglielmi Detachable Coils. Imaging Follow-Up With Contrast-Enhanced MR Angiography

Jean-Yves Gauvrit MD^*; Xavier Leclerc MD; Sabine Caron MD; Christian A. Taschner MD; Jean-Paul Lejeune MD; and Jean-Pierre Pruvo MD

From the Department of Neuroradiology and Equipe d’accueil 2691 (J.Y.G., X.L., C.A.T., S.C., J.P.P.); and the Department of Neurosurgery (J.P.L.), Hôpital Roger Salengro, University Hospital Lille, France.

^* To whom correspondence should be addressed. E-mail: jygauvrit{at}chru-lille.fr.

Background and Purpose--To compare the utility of contrast-enhanced MR Angiography (CE-MRA) with digital subtraction angiography (DSA) after endovascular treatment of intracranial aneurysms with Guglielmi detachable coils.

Methods--From April 1999 to August 2002, 106 patients with 107 aneurysms treated by endovascular coiling using Guglielmi detachable coils underwent simultaneous DSA and CE-MRA at follow-up (mean: 12.9 range: 5 to 27 months). DSA was performed as the standard reference. MR angiographic images were analyzed independently by 2 senior radiologists (J.-Y.G., S.C.) and DSA by a third radiologist (X.L.). Findings were assigned to 1 of 3 categories: complete obliteration (class 1), residual neck (class 2) and residual aneurysm (class 3).

Results--DSA at follow-up demonstrated 65 (60.6%) complete obliterations (group 1), 21 (19.7%) residual necks (group 2) and 21 (19.7%) residual aneurysms (group 3). One patient (0.9%) experienced aneurysm rebleed during the follow-up period. Among 101 assessable imaging comparisons, interobserver agreement was determined to be very good for CE-MRA (=0.96) with only 4 discrepancies between both examiners. Comparison between CE-MRA and DSA showed an excellent agreement between techniques (=0.93). Of the 21 with residual necks described on DSA, 20 were seen on CE-MRA. CE-MRA detected all 19 residual aneurysms.

Conclusion--CE-MRA after selective embolization of intracranial aneurysm is useful and comparable to DSA in the assessment of aneurysmal recanalization either as residual neck or aneurysmal sac.

Key words: endovascular therapy • intracranial aneurysm • MRA

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