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Ten unruptured aneurysms in 9 patients were studied using a high-resolution 3D gradient-echo sequence with cardiac gating. Semiautomatic segmentation was used to measure aneurysm volume per cardiac phase. Aneurysm pulsation was defined as the relative increase in volume between the phase with the smallest volume and the phase with the largest volume. The accuracy and precision of the measured volume pulsations were addressed by digital phantom simulations and a repeat image analysis. In Stage II, the imaging protocol was optimized and 9 patients with 9 aneurysms were studied with and without administration of a contrast agent. Mean aneurysm pulsation in Stage I was 8%, with a mean volume change of 15 mm3. The artifactual volume pulsations measured with the digital phantom simulations were of the same magnitude as the volume pulsations observed in the patient data. Volume pulsation quantification with the current imaging protocol on 7T MR imaging is not accurate due to multiple imaging artifacts.

Abstract

Figure 1 from paper
Coronal cross-section of a left middle cerebral artery aneurysm for each of the 15 phases of the cardiac cycle (heart rate, 60 beats per minute). The contour of the aneurysm at 0 ms is shown in yellow on all other time points. The white arrows indicate the area of pulsation in this cross-section. Magnification of 2 phases shows the deformation of the aneurysm at 1 side of the dome.

BACKGROUND AND PURPOSE

Aneurysm volume pulsation is a potential predictor of intracranial aneurysm rupture. We evaluated whether 7T MR imaging can quantify aneurysm volume pulsation.

MATERIALS AND METHODS

In Stage I of the study, 10 unruptured aneurysms in 9 patients were studied using a high-resolution (0.6-mm, isotropic) 3D gradient-echo sequence with cardiac gating. Semiautomatic segmentation was used to measure aneurysm volume (in cubic millimeters) per cardiac phase. Aneurysm pulsation was defined as the relative increase in volume between the phase with the smallest volume and the phase with the largest volume. The accuracy and precision of the measured volume pulsations were addressed by digital phantom simulations and a repeat image analysis. In Stage II, the imaging protocol was optimized and 9 patients with 9 aneurysms were studied with and without administration of a contrast agent.

RESULTS

The mean aneurysm pulsation in Stage I was 8% ± 7% (range, 2%–27%), with a mean volume change of 15 ± 14 mm3 (range, 3–51 mm3). The mean difference in volume change for the repeat image analysis was 2 ± 6 mm3. The artifactual volume pulsations measured with the digital phantom simulations were of the same magnitude as the volume pulsations observed in the patient data, even after protocol optimization in Stage II.

CONCLUSIONS

Volume pulsation quantification with the current imaging protocol on 7T MR imaging is not accurate due to multiple imaging artifacts. Future studies should always include aneurysm-specific accuracy analysis.

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