Accuracy of detecting enlargement of aneurysms using different MRI modalities and measurement protocols.

Autor:	Nakagawa D; Departments of1Neurosurgery.; 2Department of Biomedical Engineering, University of Iowa, Seamans Center for the Engineering Arts and Sciences, Iowa City., Nagahama Y; Departments of1Neurosurgery., Policeni BA; 3Radiology, and., Raghavan ML; 2Department of Biomedical Engineering, University of Iowa, Seamans Center for the Engineering Arts and Sciences, Iowa City., Dillard SI; 2Department of Biomedical Engineering, University of Iowa, Seamans Center for the Engineering Arts and Sciences, Iowa City., Schumacher AL; 2Department of Biomedical Engineering, University of Iowa, Seamans Center for the Engineering Arts and Sciences, Iowa City., Sarathy S; 2Department of Biomedical Engineering, University of Iowa, Seamans Center for the Engineering Arts and Sciences, Iowa City., Dlouhy BJ; Departments of1Neurosurgery., Wilson S; Departments of1Neurosurgery., Allan L; 4Department of General Surgery, Mercy Medical Center, Des Moines, Iowa., Woo HH; 5Department of Neurosurgery, Stony Brook University, Stony Brook, New York; Departments of., Huston J; 6Radiology and., Cloft HJ; 6Radiology and., Wintermark M; 7Department of Radiology, Stanford University Medical School, Palo Alto, California., Torner JC; 8Epidemiology, University of Iowa Hospitals and Clinics, Iowa City., Brown RD; 9Neurology, Mayo Clinic, Rochester, Minnesota; and., Hasan DM; Departments of1Neurosurgery.
Jazyk:	angličtina
Zdroj:	Journal of neurosurgery [J Neurosurg] 2019 Feb 01; Vol. 130 (2), pp. 559-565. Date of Electronic Publication: 2018 Mar 09.
DOI:	10.3171/2017.9.JNS171811
Abstrakt:	Objective: Aneurysm growth is considered predictive of future rupture of intracranial aneurysms. However, how accurately neuroradiologists can reliably detect incremental aneurysm growth using clinical MRI is still unknown. The purpose of this study was to assess the agreement rate of detecting aneurysm enlargement employing generally used MRI modalities. Methods: Three silicone flow phantom models, each with 8 aneurysms of various sizes at different sites, were used in this study. The aneurysm models were identical except for an incremental increase in the sizes of the 8 aneurysms, which ranged from 0.4 mm to 2 mm. The phantoms were imaged on 1.5-T and 3-T MRI units with both time-of-flight (TOF) and contrast-enhanced MR angiography. Three independent expert neuroradiologists measured the aneurysms in a blinded manner using different measurement approaches. The individual and agreement detection rates of aneurysm enlargement among the 3 experts were calculated. Results: The mean detection rate of any increase in any aneurysmal dimension was 95.7%. The detection rates of the 3 observers (observers A, B, and C) were 98.0%, 96.6%, and 92.7%, respectively (p = 0.22). The detection rates of each MRI modality were 91.3% using 1.5-T TOF, 97.2% using 1.5-T with Gd, 95.8% using 3.0-T TOF, and 97.2% using 3.0-T with Gd (p = 0.31). On the other hand, the mean detection rate for aneurysm enlargement was 54.8%. Specifically, the detection rates of observers A, B, and C were 49.0%, 46.1%, and 66.7%, respectively (p = 0.009). As the incremental enlargement value increased, the detection rate for aneurysm enlargement increased. The use of 1.5-T Gd improved the detection rate for small incremental enlargement (e.g., 0.4–1 mm) of the aneurysm (p = 0.04). The location of the aneurysm also affected the detection rate for aneurysm enlargement (p < 0.0001). Conclusions: The detection rate and interobserver agreement were very high for aneurysm enlargement of 0.4–2 mm. The detection rate for at least 1 increase in any aneurysm dimension did not depend on the choice of MRI modality or measurement protocol. Use of Gd improved the accuracy of measurement. Aneurysm location may influence the accuracy of detecting enlargement.
Databáze:	MEDLINE
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