- HARMless: Transient Cortical and Sulcal Hyperintensity on Gadolinium-Enhanced FLAIR after Elective Endovascular Coiling of Intracranial Aneurysms
The authorsconducted a retrospective review of 58 patients with 62 MR imaging studies performed within 72 hours following endovascular treatment of intracranial aneurysms. Patient demographics, aneurysm location, and vascular territory distribution of cortical and sulcalhyperintensity on gadolinium-enhanced FLAIR were documented. Cortical and sulcalhyperintensity on gadolinium-enhanced FLAIR was found in 51.61% of post-endovascular treatment MR imaging studies, with complete resolution of findings in all patients on the available follow-up studies (27/27). Angiographic iodinated contrast medium injection and arterial anatomy matched the vascular distribution of cortical and sulcalhyperintensity on gadolinium-enhanced FLAIR. Thishyperintensity is a transient observation in the arterial territory exposed to iodinated contrast medium during endovascular treatment of intracranial aneurysms, and is significantly associated with procedural time and the frequency of angiographic runs, suggesting a potential technical influence on the breakdown of the BBB.
- Quantification of Intracranial Aneurysm Volume Pulsation with 7T MRI
Tenunruptured 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.
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