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Usefulness of High-Resolution Three-Dimensional Proton Density-Weighted Turbo Spin-Echo MRI in Distinguishing a Junctional Dilatation From an Intracranial Aneurysm of the Posterior Communicating Artery: A Pilot Study

Authors
 Sunghan Kim  ;  Joonho Chung  ;  Jihoon Cha  ;  Byung Moon Kim  ;  Dong Joon Kim  ;  Yong Bae Kim  ;  Jae Whan Lee  ;  Seung Kon Huh  ;  Keun Young Park 
Citation
 JOURNAL OF NEUROINTERVENTIONAL SURGERY, Vol.12(3) : 315-319, 2020-03 
Journal Title
 JOURNAL OF NEUROINTERVENTIONAL SURGERY 
ISSN
 1759-8478 
Issue Date
2020-03
Keywords
aneurysm ; angiography ; magnetic resonance angiography ; magnetic resonance imaging
Abstract
Background: Discriminating a junctional dilatation from a true saccular aneurysm is clinically important. Purpose: To evaluate the usefulness of high-resolution three-dimensional proton density-weighted turbo spin-echo magnetic resonance imaging (PD MRI) in distinguishing a junctional dilatation from an aneurysm of the posterior communicating artery (PcomA). Methods: Eighty-two consecutive patients with 83 PcomA lesions, which were evaluated by time-of-flight (TOF) MR angiography (MRA), PD MRI, and digital subtraction angiography (DSA), were enrolled. These radiologic data were retrospectively and independently reviewed by two neurosurgeons, and each diagnosis based on TOF MRA, PD MRI, and DSA was compared. The diagnostic efficacy (interobserver agreement, intermodality agreement, and diagnostic performance) of PD MRI was compared with that of TOF MRA. Results: PD MRI showed higher AC1 (Gwet's agreement coefficient, PD MRI: 0.8942, 95% CI 0.8204 to 0.968; TOF MRA: 0.7185, 95% CI 0.5753 to 0.8617) and prevalence-adjusted bias-adjusted kappa coefficient (PABAK) (PD MRI: 0.8554, TOF MRA: 0.5904) than TOF MRA for interobserver agreement. For intermodality agreement, PD MRI also showed higher AC1 (PD MRI: 0.9069, 95% CI 0.8374 to 0.9764; TOF MRA: 0.7983, 95% CI 0.6969 to 0.8996) and PABAK (PD MRI: 0.8735, TOF MRA: 0.7289) than TOF MRA. The diagnostic performance of PD MRI was statistically superior to that of TOF MRA in sensitivity, specificity, positive predictive value, and negative predictive value. Conclusions: PD MRI could provide excellent diagnostic accuracy and better information in distinguishing a junctional dilatation from a true saccular aneurysm of the PcomA compared with TOF MRA.
Full Text
https://jnis.bmj.com/content/12/3/315.long
DOI
10.1136/neurintsurg-2019-015149
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Neurosurgery (신경외과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Dong Joon(김동준) ORCID logo https://orcid.org/0000-0002-7035-087X
Kim, Byung Moon(김병문) ORCID logo https://orcid.org/0000-0001-8593-6841
Kim, Yong Bae(김용배) ORCID logo https://orcid.org/0000-0003-2262-7157
Park, Keun Young(박근영)
Lee, Jae Whan(이재환)
Chung, Joon Ho(정준호)
Cha, Jihoon(차지훈)
Huh, Seung Kon(허승곤)
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/176103
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