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(Stroke. 2006;37:1033.)
© 2006 American Heart Association, Inc.

Original Contributions

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 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.

Correspondence to Jean-Yves Gauvrit, Service de Neuroradiologie, Hôpital Roger Salengro, Centre Hospitalier Régional Universitaire Lille, Boulevard Emile Laine, F-59037 Lille Cédex. 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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