• World Neurosurg · Mar 2020

    Observational Study

    Findings and prognostic value of contrast enhanced early MRI after coil embolization of cerebral aneurysms.

    • Omid Nikoubashman, Carolin Molavi Tabrizi, Malte Münstermann, Gerrit Alexander Schubert, Arno Reich, Martin Wiesmann, and Marguerite Müller.
    • Department of Neuroradiology, University Hospital RWTH Aachen, Aachen, Germany. Electronic address: onikoubashman@ukaachen.de.
    • World Neurosurg. 2020 Mar 1; 135: e382-e385.

    BackgroundRecent studies imply an association between aneurysm wall enhancement (AWE) on contrast-enhanced magnetic resonance imaging and aneurysm rupture. We investigated the prevalence and clinical significance of AWE and enhancement within the aneurysm (inner enhancement [IE]) in coiled aneurysms.MethodsWe assessed the frequency of AWE and IE after coil embolization on postinterventional magnetic resonance imaging (<6 weeks) in 30 consecutive patients with 33 aneurysms and elucidated the association between enhancement and subsequent aneurysm recurrence or hemorrhage.ResultsAWE and IE occurred in 97% and 36% of cases, respectively. There was no rehemorrhage, and there was no significant association between subsequent reperfusion and AWE (P = 0.200) or IE (P = 0.148) during a median follow-up period of 19 months. The greatest share of IE (8 of 12 aneurysms) was found in incompletely coiled aneurysms with small remnants (P = 0.001).ConclusionsAWE after coil embolization cannot be used for recurrence risk stratification owing to its high prevalence. IE is likely to represent contrast inflow in the coiled aneurysm.Copyright © 2019 Elsevier Inc. All rights reserved.

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