GIÁ TRỊ CỦA CỘNG HƯỞNG TỪ 3.0 TESLA TRONG THEO DÕI SAU CAN THIỆP ĐẶT STENT ĐỔI HƯỚNG DÒNG CHẢY ĐIỀU TRỊ PHÌNH MẠCH MÁU NÃO.
Main Article Content
Abstract
Objective: To evaluate the value of 3.0 Tesla magnetic resonance imaging (3T MRI) in the follow-up of intracranial aneurysms treated with flow diverter stents.
Materials and Methods: This descriptive study included 16 patients with intracranial aneurysms treated with flow diverter stents who underwent both 3T MRI and digital subtraction angiography (DSA) at the Center for Diagnostic Imaging and Interventional Radiology, Hanoi Medical University Hospital, from August 2025 to May 2026. The study focused on aneurysm occlusion grading using the O’Kelly-Marotta (OKM) scale, detection of residual aneurysms, and assessment of in-stent stenosis. Statistical analyses included sensitivity, specificity, accuracy, and Cohen’s Kappa coefficient to evaluate agreement between imaging modalities.
Results: The study included 16 patients with a mean age of 57.2 ± 12.3 years. Most aneurysms were located in the internal carotid artery system (93.8%), predominantly at the C6 segment according to the Bouthillier classification. For detection of residual aneurysms, 3T MRI demonstrated a sensitivity of 66.7%, specificity of 100%, accuracy of 93.8%, and negative predictive value of 92.9%, with a Kappa coefficient of 0.765 compared with DSA. In the assessment of aneurysm occlusion using the OKM grading scale, 3T MRI showed excellent agreement with DSA, with a weighted Kappa of 0.957. TOF-MRA, Silent MRA, and CE-MRA demonstrated comparable diagnostic performance in detecting residual aneurysms. For the evaluation of in-stent stenosis, 3T MRI achieved a specificity of 100%, sensitivity of 66.7%, and good agreement with DSA (Kappa = 0.765).
Conclusion: 3.0 Tesla MRI is a valuable noninvasive imaging modality for follow-up after flow diverter treatment of intracranial aneurysms, demonstrating high accuracy and specificity. It has the potential to replace DSA in routine follow-up in many stable cases, thereby reducing the risks and costs associated with invasive procedures. However, DSA remains the reference standard in cases with suspected small residual flow or when detailed evaluation of the stent lumen and adjacent branch vessels is required.
Keywords: 3.0 Tesla MRI, flow diverter stent, cerebral aneurysm, digital subtraction angiography, O'Kelly-Marotta scale.
Keywords
3.0 Tesla MRI, flow diverter stent, cerebral aneurysm, digital subtraction angiography, O'Kelly-Marotta scale.
Article Details
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