Work

Could MR Angio Replace Digital Subtraction Angiography for Verification of Occlusion Rate of Cerebral Aneurysms?

Year: 2025

Type: article

Abstract: Background/Objectives: Cerebral aneurysms affect 3–5% of the population and carry a risk of rupture. Post-treatment imaging is essential to detect residual or recurrent filling. Digital subtraction angiography (DSA) is the gold standard, but it is invasive and can have complications. Magnetic resonance angiography (MRA) is a non-invasive alternative, but its reliability in follow-up remains debated. This study evaluated the diagnostic performance of MRA compared to DSA in detecting residual flow after endovascular treatment of intracranial aneurysms. Primary outcomes were MRA’s sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) and its potential to reduce or replace DSA in follow-up. Methods: A retrospective single-center study included patients ≥ 18 years treated endovascularly for ruptured or unruptured intracranial aneurysms during 2018–2021. Each follow-up case with both DSA and MRA was independently assessed by neuroradiologists, using DSA as the reference standard. Diagnostic performance metrics were calculated. Results: Of 400 screened cases, 198 were included. MRA and DSA findings agreed in 78.3% of cases. MRA showed 69.7% sensitivity and 80.0% specificity. PPV was 41.1%, and NPV was 93.0%. There were 33 false positives and 10 false negatives. Only one false negative led to retreatment, and none of the false positives required intervention. Conclusions: MRA shows high reliability in ruling out residual aneurysm flow due to its strong NPV. Despite limitations in confirming recurrence, MRA might be a useful first-line follow-up tool, with DSA reserved for inconclusive, unclear, or artifact cases.

Source: Journal of Clinical Medicine

DOI: 10.3390/jcm14228221

Authors: Rasmus Moldt Holmager, Jonas Jensen, Troels Halfeld Nielsen, Sune Munthe

Institutions: University of Southern Denmark, Odense University Hospital, Aarhus University Hospital

Language: English

Topic: Intracranial Aneurysms: Treatment and Complications

Subfield: Neurology

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $3,137