Enhanced Preoperative Planning for Intracranial Aneurysms Through Multimodal Image Fusion of Silent/Time-of-Magnetic Resonance Angiography and Computed Tomography Using 3DSlicer: A Comparative Efficacy Analysis With Computed Tomography Angiography.

Publisher: Lippincott Williams & Wilkins Country of Publication: United States NLM ID: 9503763 Publication Model: Electronic Cited Medium: Internet ISSN: 2331-2637 (Electronic) Linking ISSN: 10747931 NLM ISO Abbreviation: Neurologist Subsets: MEDLINE

Publication: Hagerstown, MD : Lippincott Williams & Wilkins
Original Publication: Baltimore, Md : Williams & Wilkins, c1995-

Intracranial Aneurysm*/diagnostic imaging ; Intracranial Aneurysm*/surgery ; Magnetic Resonance Angiography*/methods ; Computed Tomography Angiography*; Humans ; Male ; Female ; Middle Aged ; Retrospective Studies ; Adult ; Aged ; Preoperative Care/methods ; Multimodal Imaging/methods ; Imaging, Three-Dimensional

Objective: This study evaluates the effectiveness of multimodal image fusion (MIF) using silent and time-of-flight (TOF) magnetic resonance angiography (MRA) and computed tomography (CT) for preoperative planning in patients with intracranial aneurysms who have contraindications to contrast media.
Materials and Methods: A retrospective study included 40 patients with intracranial aneurysms, diagnosed using three-dimensional computed tomography angiography (CTA). These patients underwent both Silent and TOF MRA scans, followed by a CTA scan. The multi-image fusion (MIF) technique, applied using 3DSlicer software, integrated the silent/TOF-MRA with CT images for preoperative assessment. This study compared the image quality, aneurysm detection sensitivity, and anatomic accuracy of the MIF images with those of three-dimensional CTA.
Results: Silent-MRA-CT fusion images demonstrated higher sensitivity (95.5%) and lower false negative rates (4.5%) compared with TOF-MRA-CT. Furthermore, silent-MRA-CT fusion images outperformed TOF-MRA-CT in terms of signal homogeneity, venous signal interference suppression, and aneurysm visibility (all P < 0.05). The interclass correlation coefficient and kappa values for aneurysm morphology and shape indicated superior measurement consistency and shape concordance of silent-MRA-CT with CTA compared with TOF-MRA-CT (all P < 0.01).
Conclusion: This study supports the use of silent/TOF-MRA-CT fusion imaging as a reliable alternative to CTA, noting that silent-MRA-CT closely mirrors CTA. Contrast-free MRA-CT fusion images have the potential to be used for preoperative planning in patients with intracranial aneurysms who have contraindications to contrast.
Competing Interests: The authors declare no conflict of interest.
(Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)

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Date Created: 20240923 Date Completed: 20241104 Latest Revision: 20241104

20241104

10.1097/NRL.0000000000000582

39311429