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Added diagnostic values of three-dimensional high-resolution proton density-weighted magnetic resonance imaging for unruptured intracranial aneurysms in the circle-of-Willis: Comparison with time-of-flight magnetic resonance angiography

BACKGROUND: Advanced imaging methods can enhance the identification of aneurysms of the infundibula, which can reduce unnecessary follow-ups or further work-up, fear, and anxiety in patients. PURPOSE: This study aimed to evaluate the added diagnostic value of three-dimensional proton density-weighte...

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Autores principales: Yim, Younghee, Jung, Seung Chai, Kim, Jung Youn, Kim, Seon-Ok, Kim, Byung Jun, Lee, Deok Hee, Park, Wonhyoung, Park, Jung Cheol, Ahn, Jae Sung
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7714200/
https://www.ncbi.nlm.nih.gov/pubmed/33270756
http://dx.doi.org/10.1371/journal.pone.0243235
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author Yim, Younghee
Jung, Seung Chai
Kim, Jung Youn
Kim, Seon-Ok
Kim, Byung Jun
Lee, Deok Hee
Park, Wonhyoung
Park, Jung Cheol
Ahn, Jae Sung
author_facet Yim, Younghee
Jung, Seung Chai
Kim, Jung Youn
Kim, Seon-Ok
Kim, Byung Jun
Lee, Deok Hee
Park, Wonhyoung
Park, Jung Cheol
Ahn, Jae Sung
author_sort Yim, Younghee
collection PubMed
description BACKGROUND: Advanced imaging methods can enhance the identification of aneurysms of the infundibula, which can reduce unnecessary follow-ups or further work-up, fear, and anxiety in patients. PURPOSE: This study aimed to evaluate the added diagnostic value of three-dimensional proton density-weighted vessel wall magnetic resonance imaging (3D-PD MRI) in identifying aneurysms from index lesions refer to vascular bulging lesions without vessels arising from the apex, observed using volume-rendered TOF-MRA in the circle-of-Willis compared with time-of-flight magnetic resonance angiography (TOF-MRA). STUDY TYPE: Retrospective. POPULATION: A total of 299 patients who underwent 3D-PD MRI, digital subtraction angiography (DSA), and TOF-MRA between January 2012 and December 2016 were retrospectively enrolled in this study. FIELD STRENGTH/SEQUENCE: 3 Tesla, 3D-PD MRI. ASSESSMENT: Three neuroradiologists independently evaluated TOF-MRA and 3D-PD MRI combined with TOF-MRA for the determination of intracranial aneurysms in patients with index lesions within the circle of Willis. Final diagnoses were made by another neuroradiologist and neurointerventionist in consensus using DSA as the reference standard. The diagnostic performance and proportions of undetermined lesions on TOF-MRA and 3D-PD MRI with TOF-MRA were assessed based on the final diagnoses. STATISTICAL TESTS: The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy for the diagnosis of unruptured intracranial aneurysms were calculated for each imaging modality. RESULTS: Of 452 lesions identified on volume-rendered TOF-MRA images, 173 (38%) aneurysms and 276 (61%) infundibula were finally diagnosed on DSA. 3D-PD MRI with TOF-MRA showed superior diagnostic performance (p = .001; accuracy, 85.5% versus 95.4%), superior area under the receiver operating characteristic curve over TOF-MRA (p = .001; 0.837 versus 0.947), and a lower proportion of undetermined lesions than TOF-MRA (p = .001; 25.1% versus 2.3%). DATA CONCLUSION: For unruptured intracranial aneurysms in the circle of Willis, 3D-PD MRI can complement TOF-MRA to improve diagnostic performance and lower the proportion of undetermined lesions.
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spelling pubmed-77142002020-12-09 Added diagnostic values of three-dimensional high-resolution proton density-weighted magnetic resonance imaging for unruptured intracranial aneurysms in the circle-of-Willis: Comparison with time-of-flight magnetic resonance angiography Yim, Younghee Jung, Seung Chai Kim, Jung Youn Kim, Seon-Ok Kim, Byung Jun Lee, Deok Hee Park, Wonhyoung Park, Jung Cheol Ahn, Jae Sung PLoS One Research Article BACKGROUND: Advanced imaging methods can enhance the identification of aneurysms of the infundibula, which can reduce unnecessary follow-ups or further work-up, fear, and anxiety in patients. PURPOSE: This study aimed to evaluate the added diagnostic value of three-dimensional proton density-weighted vessel wall magnetic resonance imaging (3D-PD MRI) in identifying aneurysms from index lesions refer to vascular bulging lesions without vessels arising from the apex, observed using volume-rendered TOF-MRA in the circle-of-Willis compared with time-of-flight magnetic resonance angiography (TOF-MRA). STUDY TYPE: Retrospective. POPULATION: A total of 299 patients who underwent 3D-PD MRI, digital subtraction angiography (DSA), and TOF-MRA between January 2012 and December 2016 were retrospectively enrolled in this study. FIELD STRENGTH/SEQUENCE: 3 Tesla, 3D-PD MRI. ASSESSMENT: Three neuroradiologists independently evaluated TOF-MRA and 3D-PD MRI combined with TOF-MRA for the determination of intracranial aneurysms in patients with index lesions within the circle of Willis. Final diagnoses were made by another neuroradiologist and neurointerventionist in consensus using DSA as the reference standard. The diagnostic performance and proportions of undetermined lesions on TOF-MRA and 3D-PD MRI with TOF-MRA were assessed based on the final diagnoses. STATISTICAL TESTS: The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy for the diagnosis of unruptured intracranial aneurysms were calculated for each imaging modality. RESULTS: Of 452 lesions identified on volume-rendered TOF-MRA images, 173 (38%) aneurysms and 276 (61%) infundibula were finally diagnosed on DSA. 3D-PD MRI with TOF-MRA showed superior diagnostic performance (p = .001; accuracy, 85.5% versus 95.4%), superior area under the receiver operating characteristic curve over TOF-MRA (p = .001; 0.837 versus 0.947), and a lower proportion of undetermined lesions than TOF-MRA (p = .001; 25.1% versus 2.3%). DATA CONCLUSION: For unruptured intracranial aneurysms in the circle of Willis, 3D-PD MRI can complement TOF-MRA to improve diagnostic performance and lower the proportion of undetermined lesions. Public Library of Science 2020-12-03 /pmc/articles/PMC7714200/ /pubmed/33270756 http://dx.doi.org/10.1371/journal.pone.0243235 Text en © 2020 Yim et al http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Yim, Younghee
Jung, Seung Chai
Kim, Jung Youn
Kim, Seon-Ok
Kim, Byung Jun
Lee, Deok Hee
Park, Wonhyoung
Park, Jung Cheol
Ahn, Jae Sung
Added diagnostic values of three-dimensional high-resolution proton density-weighted magnetic resonance imaging for unruptured intracranial aneurysms in the circle-of-Willis: Comparison with time-of-flight magnetic resonance angiography
title Added diagnostic values of three-dimensional high-resolution proton density-weighted magnetic resonance imaging for unruptured intracranial aneurysms in the circle-of-Willis: Comparison with time-of-flight magnetic resonance angiography
title_full Added diagnostic values of three-dimensional high-resolution proton density-weighted magnetic resonance imaging for unruptured intracranial aneurysms in the circle-of-Willis: Comparison with time-of-flight magnetic resonance angiography
title_fullStr Added diagnostic values of three-dimensional high-resolution proton density-weighted magnetic resonance imaging for unruptured intracranial aneurysms in the circle-of-Willis: Comparison with time-of-flight magnetic resonance angiography
title_full_unstemmed Added diagnostic values of three-dimensional high-resolution proton density-weighted magnetic resonance imaging for unruptured intracranial aneurysms in the circle-of-Willis: Comparison with time-of-flight magnetic resonance angiography
title_short Added diagnostic values of three-dimensional high-resolution proton density-weighted magnetic resonance imaging for unruptured intracranial aneurysms in the circle-of-Willis: Comparison with time-of-flight magnetic resonance angiography
title_sort added diagnostic values of three-dimensional high-resolution proton density-weighted magnetic resonance imaging for unruptured intracranial aneurysms in the circle-of-willis: comparison with time-of-flight magnetic resonance angiography
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7714200/
https://www.ncbi.nlm.nih.gov/pubmed/33270756
http://dx.doi.org/10.1371/journal.pone.0243235
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