Susceptibility weighted imaging for ruptured basilar artery perforator aneurysms in the setting of angiographically negative subarachnoid hemorrhage.

Autor:	Zhu F; Department of Diagnostic and Interventional Neuroradiology, CHRU Nancy, Nancy, France f.zhu@chru-nancy.fr.; IADI, INSERM U1254, Université de Lorraine, Nancy, France., Liao L; Department of Diagnostic and Interventional Neuroradiology, CHRU Nancy, Nancy, France.; INRIA, LORIA, CNRS, Université de Lorraine, Nancy, France., Bracard S; Department of Diagnostic and Interventional Neuroradiology, CHRU Nancy, Nancy, France.; IADI, INSERM U1254, Université de Lorraine, Nancy, France., Derelle AL; Department of Diagnostic and Interventional Neuroradiology, CHRU Nancy, Nancy, France., Muszynski P; Department of Diagnostic and Interventional Neuroradiology, CHRU Nancy, Nancy, France.; Instituto Oulton, Cordoba, Argentina., Merlot I; Department of Neurosurgery, CHRU Nancy, Nancy, France., Planel S; Department of Diagnostic and Interventional Neuroradiology, CHRU Nancy, Nancy, France., Schmitt E; Department of Diagnostic and Interventional Neuroradiology, CHRU Nancy, Nancy, France., Braun M; Department of Diagnostic and Interventional Neuroradiology, CHRU Nancy, Nancy, France.; IADI, INSERM U1254, Université de Lorraine, Nancy, France., Gory B; Department of Diagnostic and Interventional Neuroradiology, CHRU Nancy, Nancy, France.; IADI, INSERM U1254, Université de Lorraine, Nancy, France., Anxionnat R; Department of Diagnostic and Interventional Neuroradiology, CHRU Nancy, Nancy, France.; IADI, INSERM U1254, Université de Lorraine, Nancy, France.
Jazyk:	angličtina
Zdroj:	Journal of neurointerventional surgery [J Neurointerv Surg] 2023 Oct; Vol. 15 (10), pp. 1046-1049. Date of Electronic Publication: 2022 Sep 26.
DOI:	10.1136/jnis-2022-019269
Abstrakt:	Background: Ruptured basilar artery perforator aneurysms (BAPAs), defined as microaneurysms which develop in basilar perforator arteries without direct involvement of the basilar trunk, represent a rare cause of subarachnoid hemorrhage (SAH). The diagnosis of BAPAs is difficult because of their small size, with high rates of negative angiography. The development of high-resolution MRI could increase the diagnostic performance. In this study we describe the usefulness of susceptibility weighted imaging (SWI) for the diagnosis of ruptured BAPAs. Methods: In a case series, we retrospectively collected data of patients admitted to our institution from 2018 to 2021 for SAH with negative CT angiography who underwent MRI (including SWI) and DSA during hospitalization. Results: Eight patients with a definitive diagnosis of ruptured BAPA and five patients with a definitive diagnosis of angiogram-negative SAH were included. In all of the patients with BAPAs MRI showed a focal, thick, semi-circumferential SWI hypointensity covering the vessel wall at the level of the BAPA subsequently revealed on DSA; this phenomen is known as 'SWI capping'. No SWI capping was observed in the five patients with a definitive diagnosis of angiogram-negative SAH. Conclusion: SWI capping appears to be a reliable indirect sign for the diagnosis and localization of ruptured BAPAs, a rare form of microaneurysm easily misdiagnosed on DSA in initial angiogram-negative SAH. Competing Interests: Competing interests: None declared. (© Author(s) (or their employer(s)) 2023. No commercial re-use. See rights and permissions. Published by BMJ.)
Databáze:	MEDLINE
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