Follow-up after embolization of ruptured intracranial aneurysms: A prospective comparison of two-dimensional digital subtraction angiography, three-dimensional digital subtraction angiography, and time-of-flight magnetic resonanceReportar como inadecuado




Follow-up after embolization of ruptured intracranial aneurysms: A prospective comparison of two-dimensional digital subtraction angiography, three-dimensional digital subtraction angiography, and time-of-flight magnetic resonance - Descarga este documento en PDF. Documentación en PDF para descargar gratis. Disponible también para leer online.

Neuroradiology

, Volume 54, Issue 11, pp 1253–1260

First Online: 10 April 2012Received: 13 December 2011Accepted: 12 March 2012

Abstract

IntroductionTo prospectively compare of the diagnostic value of digital subtraction angiography DSA and time-of-flight magnetic resonance angiography TOF-MRA in the follow-up of intracranial aneurysms after endovascular treatment.

MethodsSeventy-two consecutive patients were examined 3 months after the embolization. The index tests included: two-dimensional DSA 2D-DSA, three-dimensional DSA 3D-DSA, and TOF-MRA. The reference test was a retrospective consensus between 2D-DSA images, 3D-DSA images, and source rotational DSA images. The evaluation included: detection of the residual flow, quantification of the flow, and validity of the decision regarding retreatment. Intraobserver agreement and interobserver agreement were determined.

ResultsThe sensitivity and specificity of residual flow detection ranged from 84.6 % 2D-DSA and TOF-MRA to 92.3 % 3D-DSA and from 91.3 % TOF-MRA to 97.8 % 3D-DSA, respectively. The accuracy of occlusion degree evaluation ranged from 0.78 2D-DSA to 0.92 3D-DSA, Cohen’s kappa. The 2D-DSA method presented lower performance in the decision on retreatment than 3D-DSA P < 0.05, ROC analysis. The intraobserver agreement was very good for all techniques κ = 0.80–0.97. The interobserver agreement was moderate for TOF-MRA and very good for 2D-DSA and 3D-DSA κ = 0.72–0.94.

ConclusionConsidering the invasiveness of DSA and the minor difference in the diagnostic performance between 3D-DSA and TOF-MRA, the latter method should be the first-line modality for follow-up after aneurysm embolization.

KeywordsIntracranial aneurysm Therapeutic embolization Cerebral angiography Magnetic resonance angiography Follow-up studies  Download fulltext PDF



Autor: Zbigniew Serafin - Piotr Strześniewski - Władysław Lasek - Wojciech Beuth

Fuente: https://link.springer.com/







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