Surveillance of intracranial aneurysms treated with detachable coils: a comparison of MRA techniques

Two MRA techniques were evaluated for the follow-up of coiled intracranial aneurysms. Twenty-nine coiled aneurysms were evaluated for a total of 36 follow-up assessments using 3D time-of flight MRA (TOF MRA), an auto-triggered elliptic–centric-ordered three-dimensional gadolinium-enhanced MR angiogram (ATECO MRA), as well as a selective digital subtraction angiography (DSA), which served as the “gold standard”. Confident visualization was seen in 36 (100%) of ATECO MRAs and in 32 (89%) of the TOF MRAs. Eleven residual aneurysm components (RACs) greater than 2 mm were described on DSA. Of these, nine were seen on ATECO MRA (sensitivity of 81% and specificity of 88%) and four were seen on TOF MRA (sensitivity of 40% and specificity of 90%). The two RACs not seen on ATECO MRA both measured 3 mm. The six RACs not seen on TOF MRA measured 3, 4 and 5 mm. ATECO MRA provides a non-invasive reliable angiogram for the surveillance of coiled aneurysms and is superior to TOF MRA for this purpose.