New technique: the use of the THRIVE sequence in the follow-up of patients who received endovascular intracranial aneury
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INTERVENTIONAL NEURORADIOLOGY
New technique: the use of the THRIVE sequence in the follow-up of patients who received endovascular intracranial aneurysm treatment Emre Mırçık 1
&
Bahattin Hakyemez 2
Received: 18 May 2020 / Accepted: 16 August 2020 # Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Purpose To determine the diagnostic accuracy of 3D time of flight MR angiography (TOF-MRA), contrast enhanced MR angiography (CE-MRA), and T1-weighted high-resolution isotropic volume examination (THRIVE) at 3 T for the evaluation of intracranial aneurysm occlusion after endovascular treatment and to evaluate the usability of the THRIVE sequence in endovascular treatment follow-up. Methods In 3 T MR follow-up examinations of 66 aneurysms in 50 patients treated endovascularly, 3D TOF-MRA (index test), THRIVE (index test), and CE-MRA (reference standard) examinations were performed in a retrospective consecutive case series. Source images were classified as class 1, class 2, and class 3 according to the Raymond criteria using MIP (maximum intensity projection) techniques. The compatibility between sequences was evaluated with the Kappa test. The sensitivity and specificity were also calculated. Results In the evaluation of THRIVE and CE-MRA sequences, compatibility was determined in 61 cases in total, with an overall fit of 61/66 (92.42%). A statistically significant correlation was found between THRIVE and CE-MRA (p < 0.001, κ = 0.800). In the evaluation of TOF and CE-MRA sequences, compatibility was determined in 54 cases in total, and the overall fit was 54/66 (81.8%). A statistically significant agreement was found between TOF and CE-MRA (p < 0.001, κ = 0.502). Assuming that CEMRA is a reference standard, the sensitivity and specificity of the TOF sequence were 44.4% and 97.9%, respectively, and the sensitivity and specificity of the THRIVE sequence were 77.8% and 97.9%, respectively. Conclusion The THRIVE sequence can be used as a noncontrast method for monitoring endovascularly treated intracranial aneurysms. Keywords CE-MR . Follow-up aneurysm . MR angiography . THRIVE . TOF
Introduction Intracranial aneurysms have significant neurological mortality and morbidity. Treatment options include surgical intervention or endovascular therapy [1]. Endovascular treatment is the firstline treatment method in most aneurysms. The purpose of longterm follow-up for these aneurysms is to determine possible recurrence and to evaluate retreatment if necessary [2, 3]. * Bahattin Hakyemez [email protected] 1
Department of Radiology, Patnos State Hospital, 04500 Patnos, Ağrı, Turkey
2
Department of Radiology, Bursa Uludag University Faculty of Medicine, 16059, Nilüfer, Bursa, Turkey
Digital subtraction angiography (DSA) used for diagnostic procedures and posttreatment follow-up is a more sensitive method with a high accuracy rate when compared to all other imaging techniques and is considered the gold standard method. However, catheter angiography is an invasive diagnostic method with the disadvantages
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