Magnetic Resonance Imaging Follow-Up of Large or Giant Vertebrobasilar Dissecting Aneurysms After Total Embolization on Angiography

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• 作者：Yisen Zhang¹ ; Yanmin Wang³ ; Binbin Sui² ; Youxiang Li¹ ; Shiqing Mu¹ ; Ying Zhang¹ ; Zhongxue Wu¹ ; Xinjian Yang¹ ; ^{yang-xj@163.net" class="auth_mail" title="E-mail the corresponding author}
• 关键词：Dissection ; Endovascular techniques ; Intracranial aneurysms ; Magnetic resonance imaging
• 刊名：World Neurosurgery
• 出版年：2016
• 出版时间：July 2016
• 年：2016
• 卷：91
• 期：Complete
• 页码：218-227
• 全文大小：4055 K

文摘

To evaluate the outcomes of large or giant vertebrobasilar dissecting aneurysms (VBDAs) after endovascular total embolization by follow-up 3T magnetic resonance imaging (MRI).

Methods

Between November 2011 and July 2015, 4 patients had unruptured large or giant VBDAs that were treated with endovascular techniques with total embolization of VBDAs confirmed on follow-up angiography, but the patients had persistent or worsened symptoms. Preoperative and postoperative 3T high-resolution MRI was performed to evaluate arterial wall evolution.

Results

Follow-up angiographic results were satisfactory in all 4 patients; however, symptoms in cases 1, 2, and 4 worsened, and symptoms in case 3 did not improve. Postoperative high-resolution MRI in case 1 showed a new intramural hematoma, and postoperative high-resolution MRI of cases 2, 3, and 4 showed persistent intramural hemorrhagic signals. Follow-up MRI showed increased aneurysm size in cases 1, 2, and 4 but no size change in case 3.

Conclusions

The efficacy of conventional endovascular treatment (e.g., internal trapping with coils, stent-assisted coiling, and stent placement without coils) for large or giant VBDAs is uncertain. Follow-up angiography alone does not adequately predict the outcome. High-resolution MRI is a worthwhile adjunct to follow these lesions.