• J Neuroimaging · May 2021

    Geometric parameters on MRA source images to differentiate small Proximal Posterior communicating artery aneurysms from Infundibular dilation.

    • Yun Ji Kim, Dae Young Yoon, Eun Soo Kim, Eun Joo Yun, Hong Jun Jeon, Jong Young Lee, and Byung-Moon Cho.
    • Department of Radiology, Kangdong Seong-Sim Hospital, Hallym University College of Medicine, Seoul, South Korea.
    • J Neuroimaging. 2021 May 1; 31 (3): 532-540.

    Background And PurposeWe aimed to assess the accuracy of magnetic resonance angiography (MRA) in the differentiation of small aneurysms versus infundibular dilations (IDs) at the internal carotid artery-posterior communicating artery (ICA-PComA) junction, emphasizing the role of MRA axial source images.MethodsThis retrospective study consisted of 83 focal arterial protrusions at ICA-PComA junction in 76 patients who underwent both MRA and digital subtraction angiography (DSA)/3-dimensional rotational angiography (3DRA). The diagnostic performance of MRA for differential diagnosis of aneurysm from ID was calculated using DSA/3DRA interpretation as the standard of reference. In addition, long-axis diameter, short-axis diameter, long-axis diameter/short-axis diameter (L/S) ratio, and angle of lesion (angle of the long-axis of lesion with respect to the x-axis) measured on MRA source images were compared between aneurysms and IDs.ResultsSensitivity, specificity, and accuracy of MRA for distinguishing aneurysms from IDs were 74.4% (57.9-87.0%) to 76.9% (60.7-88.9%), 93.2% (81.3-98.6%) to 95.5% (84.5-99.4%), and 85.5% (76.1-92.3%), respectively. Significant differences were found for the long-axis diameter (P < .001), short-axis diameter (P < .001), L/S ratio (P < .05), and angle of the lesion (P < .001) on MRA axial source images between aneurysms and IDs. The angle of the lesion had the highest discriminatory ability (area under the curve = .966 [.902-.994]) to differentiate aneurysms from IDs. An angle of lesion >60° was 89.7% (75.8-97.1%) sensitive and 100% (92.0-100.0%) specific for diagnosis of aneurysm.ConclusionsMRA is a useful imaging modality for distinguishing between aneurysm and ID at the ICA-PComA junction. Furthermore, geometric parameters on MRA axial source images can provide added value in their differentiation.© 2021 American Society of Neuroimaging.

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