Visualization of Intracranial Aneurysms Treated with Woven EndoBridge Devices using Ultrashort TE MR Imaging

Daniel Toth; Stefan Sommer; Riccardo Ludovichetti; Markus Klarhoefer; Jawid Madjidyar; Patrick Thurner; Marco Piccirelli; Miklos Krepsuka; Tim Finkenstädt; Roman Guggenberger; Sebastian Winklhofer; Zsolt Kulcsar; Tilman Schubert

doi:10.3174/ajnr.A8401

Visualization of Intracranial Aneurysms Treated with Woven EndoBridge Devices using Ultrashort TE MR Imaging

AJNR Am J Neuroradiol. 2024 Oct 31. doi: 10.3174/ajnr.A8401. Online ahead of print.

Authors

Affiliations

¹ From the Department of Neuroradiology (D.T., R.L., J.M., P.T., M.P., M.K., T.F., S.W., Z.K., T.S.), Clinical Neuroscience Center, University Hospital Zurich, Zurich, Switzerland.
² Siemens Healthcare (S.S., M.K.), Zurich, Switzerland.
³ Swiss Center for Musculoskeletal Imaging (S.S.), Balgrist Campus, Zurich, Switzerland.
⁴ Advanced Clinical Imaging Technology (S.S.), Siemens Healthcare, Lausanne, Switzerland.
⁵ Department of Radiology (T.F., R.G.), University Hospital Zürich, Zürich, Switzerland.
⁶ From the Department of Neuroradiology (D.T., R.L., J.M., P.T., M.P., M.K., T.F., S.W., Z.K., T.S.), Clinical Neuroscience Center, University Hospital Zurich, Zurich, Switzerland Tilman.schubert@usz.ch.

PMID: 38997121
DOI: 10.3174/ajnr.A8401

Abstract

Background and purpose: Assessing the treatment success of intracranial aneurysms treated with Woven EndoBridge (WEB) devices using MRI is important in follow-up imaging. Depicting both the device configuration as well as reperfusion is challenging due to susceptibility artifacts. We evaluated the usefulness of the contrast-enhanced 3D ultrashort TE (UTE) sequence in this setting.

Materials and methods: In this prospective study, 12 patients (9 women) with 15 treated aneurysms were included. These 12 patients underwent 18 MRI examinations. Follow-up UTE-MRI controls were performed on the same 3T scanner. We compared the visualization of device configuration, artifact-related virtual stenosis of the parent vessel, and the WEB occlusion scale in 3D isotropic UTE-MRI postcontrast with standard TOF-MRA with contrast-enhancement (CE) and without IV contrast as well as DSA. Two interventional neuroradiologists rated the images separately and in consensus.

Results: Visualization of the WEB device position and configuration was rated superior or highly superior using the UTE sequence in 17/18 MRIs compared with TOF-MRA. Artifact-related virtual stenosis of the parent vessel was significantly lower in UTE-MRI compared with TOF and CE-TOF. Reperfusion was visible in 8/18 controls on DSA. TOF was able to grade reperfusion correctly in 16 cases; CE-TOF, in 16 cases; and UTE, in 17 cases.

Conclusions: Contrast-enhanced UTE is a novel MRI sequence that shows benefit compared with the standard sequences in noninvasive and radiation-free follow-up imaging of intracranial aneurysms treated using the WEB device.