Investigative Magnetic Resonance Imaging

Korean Society of Magnetic Resonance in Medicine (대한자기공명의과학회)
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Magnetization Transfer Contrast Angiography for Organized Thrombosed Intracranial Aneurysm in TOF MR Angiography: a Case Report

  • Kang, Dong-Hun (Department of Neurosurgery, Kyungpook National University, School of Medicine) ;
  • Lee, Hui Joong (Department of Radiology, Kyungpook National University, School of Medicine)
  • Received : 2018.08.02
  • Accepted : 2018.10.18
  • Published : 2018.12.30
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Abstract

A 66-year-old woman was referred for treatment of incidental detection of two intracranial aneurysms. Time-of-flight MR angiography (TOF MRA) revealed two aneurysms at the M1 segment of the right middle cerebral artery, and clinoid segment of left internal carotid artery, respectively. On digital subtraction angiography, there was a saccular aneurysm on the left internal carotid artery, but the other aneurysm was not detected on the right middle cerebral artery. Based on comprehensive review of imaging findings, organized thrombosed aneurysm was judged as the most likely diagnosis. In the presented report, magnetization transfer (MT) pulse to TOF MRA was used, to differentiate aneurysm-mimicking lesion on TOF MRA. We report that MT technique could be effective in differentiating true aneurysm, from possible T1 high signal artifact on TOF MRA.

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References

  1. Wolff SD, Balaban RS. Magnetization transfer contrast (MTC) and tissue water proton relaxation in vivo. Magn Reson Med 1989;10:135-144 https://doi.org/10.1002/mrm.1910100113
  2. Henkelman RM, Stanisz GJ, Graham SJ. Magnetization transfer in MRI: a review. NMR Biomed 2001;14:57-64 https://doi.org/10.1002/nbm.683
  3. Pike GB, Hu BS, Glover GH, Enzmann DR. Magnetization transfer time-of-flight magnetic resonance angiography. Magn Reson Med 1992;25:372-379 https://doi.org/10.1002/mrm.1910250217
  4. Edelman RR, Ahn SS, Chien D, et al. Improved time-offlight MR angiography of the brain with magnetization transfer contrast. Radiology 1992;184:395-399 https://doi.org/10.1148/radiology.184.2.1620835
  5. Atkinson D, Brant-Zawadzki M, Gillan G, Purdy D, Laub G. Improved MR angiography: magnetization transfer suppression with variable flip angle excitation and increased resolution. Radiology 1994;190:890-894 https://doi.org/10.1148/radiology.190.3.8115646
  6. Nezafat R, Han Y, Peters DC, et al. Coronary magnetic resonance vein imaging: imaging contrast, sequence, and timing. Magn Reson Med 2007;58:1196-1206 https://doi.org/10.1002/mrm.21395
  7. Lin W, Tkach JA, Haacke EM, Masaryk TJ. Intracranial MR angiography: application of magnetization transfer contrast and fat saturation to short gradient-echo, velocity-compensated sequences. Radiology 1993;186:753-761 https://doi.org/10.1148/radiology.186.3.8430184
  8. Anderson CM, Saloner D, Tsuruda JS, Shapeero LG, Lee RE. Artifacts in maximum-intensity-projection display of MR angiograms. AJR Am J Roentgenol 1990;154:623-629 https://doi.org/10.2214/ajr.154.3.2106232
  9. Wilcock DJ, Jaspan T, Worthington BS. Problems and pitfalls of 3-D TOF magnetic resonance angiography of the intracranial circulation. Clin Radiol 1995;50:526-532 https://doi.org/10.1016/S0009-9260(05)83186-1
  10. Wermer MJ, van der Schaaf IC, Velthuis BK, Majoie CB, Albrecht KW, Rinkel GJ. Yield of short-term follow-up CT/MR angiography for small aneurysms detected at screening. Stroke 2006;37:414-418 https://doi.org/10.1161/01.STR.0000199077.06390.35
  11. Soila KP, Viamonte M Jr, Starewicz PM. Chemical shift misregistration effect in magnetic resonance imaging. Radiology 1984;153:819-820 https://doi.org/10.1148/radiology.153.3.6494479
  12. Sankhla SK, Gunawardena WJ, Coutinho CM, Jones AP, Keogh AJ. Magnetic resonance angiography in the management of aneurysmal subarachnoid haemorrhage: a study of 51 cases. Neuroradiology 1996;38:724-729 https://doi.org/10.1007/s002340050336
  13. Litt AW. MR angiography of intracranial aneurysms: proceed, but with caution. AJNR Am J Neuroradiol 1994;15:1615-1616
  14. Wardlaw JM, White PM. The detection and management of unruptured intracranial aneurysms. Brain 2000;123 (Pt 2):205-221 https://doi.org/10.1093/brain/123.2.205
  15. Okahara M, Kiyosue H, Yamashita M, et al. Diagnostic accuracy of magnetic resonance angiography for cerebral aneurysms in correlation with 3D-digital subtraction angiographic images: a study of 133 aneurysms. Stroke 2002;33:1803-1808 https://doi.org/10.1161/01.STR.0000019510.32145.A9
  16. Horikoshi T, Fukamachi A, Nishi H, Fukasawa I. Detection of intracranial aneurysms by three-dimensional time-offlight magnetic resonance angiography. Neuroradiology 1994;36:203-207 https://doi.org/10.1007/BF00588131
  17. Adams WM, Laitt RD, Jackson A. The role of MR angiography in the pretreatment assessment of intracranial aneurysms: a comparative study. AJNR Am J Neuroradiol 2000;21:1618-1628
  18. Kemmling A, Noelte I, Gerigk L, Singer S, Groden C, Scharf J. A diagnostic pitfall for intracranial aneurysms in time-offlight MR angiography: small intracranial lipomas. AJR Am J Roentgenol 2008;190:W62-67
  19. Trungu S, Bruzzaniti P, Forcato S, Cimatti M, Raco A. Completely thrombosed distal middle cerebral artery aneurysm mimicking a cavernous angioma: case report and review of the literature. World Neurosurg 2017;103:955 e951-955 e954
  20. Qiao Y, Hallock KJ, Hamilton JA. Magnetization transfer magnetic resonance of human atherosclerotic plaques ex vivo detects areas of high protein density. J Cardiovasc Magn Reson 2011;13:73 https://doi.org/10.1186/1532-429X-13-73