Abstract 165: Accuracy of Detecting Enlargement of Aneurysms Using Different MRI Imaging Modalities and Measurement Protocols

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Objective: Aneurysm growth is considered predictive of future rupture of intracranial aneurysms. However, it is still unknown how accurately neuroradiologists can reliably detect incremental aneurysm growth using clinical magnetic resonance imaging (MRI) imaging. The purpose of this study is to assess the agreement rate of detecting aneurysm enlargement using generally used MRI imaging modalities.Methods: Three silicone flow phantom models each with eight aneurysms of various sizes in different sites were used in this study. The aneurysm models were identical except for an incremental increase in size of the 8 aneurysms ranging from 0.4mm to 2mm. The phantoms were imaged on 1.5 tesla (T) and 3T MRI units with both time-of-flight (TOF) and contrast enhanced magnetic resonance angiography (MRA). Three independent expert neuroradiologists measured the aneurysms in a blinded fashion utilizing different measurement approaches. The individual and agreement rate among the three experts in detecting aneurysm enlargement were calculated.Results: The average detection rate of any increase in any aneurysmal dimensions was 95.7%. The detection rate for the three readers (A, B and C) was 98.0%, 96.6% and 92.7%, respectively (P=0.22). The detection rate in each MRI modality was 91.3% using 1.5 T TOF, 97.2% using 1.5T gadolinium (Gad), 95.8% using 3.0T TOF and 97.2% using 3.0T Gad (P=0.31). As the incremental enlargement value increased, the detection rate for aneurysm enlargement increased. Use of Gad in 1.5T improved the detection rate in small incremental enlargement (e.g. 0.4 - 1mm) of the aneurysm (P=0.04). The locations of the aneurysms also affected detection rate for aneurysm enlargement (P<0.0001).Conclusions: The detection rate and interobserver agreement was very high for aneurysm enlargement of 0.4mm to 2 mm. Detection rate of any increase in any aneurysmal dimensions did not depend on the choice of MRI imaging modalities and measurement protocols.

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