Assessing Blood Flow in an Intracranial Stent: A Feasibility Study of MR Angiography Using a Silent Scan after Stent-Assisted Coil Embolization for Anterior Circulation Aneurysms

AJNR Am J Neuroradiol. 2015 May;36(5):967-70. doi: 10.3174/ajnr.A4199. Epub 2014 Dec 18.

Abstract

Background and purpose: Blood flow in an intracranial stent cannot be visualized with 3D time-of-flight MR angiography owing to magnetic susceptibility and radiofrequency shielding. As a novel follow-up tool after stent-assisted coil embolization, we applied MRA by using a Silent Scan algorithm that contains an ultrashort TE combined with an arterial spin-labeling technique (Silent MRA). The purpose of this study was to determine whether Silent MRA could visualize flow in an intracranial stent placed in the anterior circulation.

Materials and methods: Nine patients treated with stent-assisted coil embolization for anterior circulation aneurysms underwent MRAs (Silent MRA and TOF MRA) and x-ray digital subtraction angiography. MRAs were performed in the same session on a 3T unit. Two neuroradiologists independently reviewed the MRA images and subjectively scored flow in a stent as 1 (not visible) to 4 (excellent) by referring to the latest x-ray digital subtraction angiography image as a criterion standard.

Results: Both observers gave MRA higher scores than TOF MRA for flow in a stent in all cases. The mean score for Silent MRA was 3.44 ± 0.53, and for TOF MRA, it was 1.44 ± 0.46 (P < .001).

Conclusions: Silent MRA was able to visualize flow in an intracranial stent more effectively than TOF MRA. Silent MRA might be useful for follow-up imaging after stent-assisted coil embolization, though these study results may be only preliminary due to some limitations.

MeSH terms

  • Adult
  • Aged
  • Algorithms*
  • Angiography, Digital Subtraction / methods
  • Cerebral Angiography / methods*
  • Embolization, Therapeutic / methods*
  • Feasibility Studies
  • Female
  • Follow-Up Studies
  • Humans
  • Intracranial Aneurysm / diagnosis*
  • Intracranial Aneurysm / surgery
  • Magnetic Resonance Angiography / methods*
  • Male
  • Middle Aged
  • Spin Labels
  • Stents

Substances

  • Spin Labels