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Unruptured Cerebral Aneurysms; the Features of Cases Undetected with MR Angiography Hiroyuki KATANO 1,3 , Kunio KARASAWA 1 , Naotake SUGIYAMA 1 , Nobuko YAMASHITA 1 , Shigeru SASAKI 2 , Ken KAMIYA 1 , Kazuo YAMADA 3 1Department of Neurosurgery,Nagoya City Higashi General Hospital 2Department of Radiology,Nagoya City Higashi General Hospital 3Department of Neurosurgery and Restorative Neuroscinece,Nagoya City University Guraduate School of Medical Scinece Keyword: magnetic resonance angiography , digital subtraction angiography , unruptured cerebral aneurysm , brain dock , false-negative pp.587-594
Published Date 2004/6/1
DOI https://doi.org/10.11477/mf.1436100399
  • Abstract
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 With the development of MRI and MRA,many unruptured aneurysms have been detected and treated. Nevertheless,not a few false-positive and false-negative cases are found. We investigate aneurysms that were suspected after screening MRA at the neurosurgical outpatient clinic and the features of aneurysms detected not with MRA but with DSA were studied. Seventy-six patients (85 aneurysms) were suspected due to screening MRA and DSA was performed in 64 (71 aneurysms) of them. Correct diagnosis of cerebral aneurysms with MRA was obtained in 44 patients (45 aneurysms,63.4%),while false-negative cases were found in 17 patients (plus 20 aneurysms) and false-positive cases in 7 patients (10 aneurysms). The accuracy was 97.2% in ACA,93% in MCA,94.4% in VA-BA,and 78.9% in IC,while the sensitivity 100%,88.2%,81.8%,64.7% and the specificity 96.5%,94.4%,96.7%,91.9%,respectively. The features of aneurysms correctly diagnosed with MRA were relatively large ACA,including AcoA,MCA and VA-BA aneurysms,whereas the features of aneurysms undetected with MRA were small IC aneurysms (1-3mm in diameter),especially at the C2-3 portion. These aneurysms at the C2-3portion or at unusual portions tended to be difficult to detect even with 3D-CTA. Though most of the aneurysms detected with DSA but not with MRA tended to be small and not interventionally treated in the present study,we should pay attention to the fact that these aneurysms are overlooked despite the possibility that they may become enlarged or rupture. Though ruptured aneurysms were surgically treated with only MRA or 3D-CTA without conventional angiography in these days,we recommend the examination of the unruptured cases,which are usually asymptomatic and not hasty,with precise inspection by target MIP,high-performance 3D-CTA or DSA.


Copyright © 2004, Igaku-Shoin Ltd. All rights reserved.

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電子版ISSN 1882-1251 印刷版ISSN 0301-2603 医学書院

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