Preliminary application of high-resolution magnetic resonance vessel wall imaging in follow-up of vertebrobasilar artery dissecting aneurysms post endovascular treatment

Objective To evaluate the utilization of high-resolution magnetic resonance vessel wall imaging (HR-VWI) in follow-up of vertebrobasilar artery dissecting aneurysms post endovascular treatment. Methods A retrospective study was conducted on 10 patients with vertebrobasilar artery dissecting aneurysms who underwent endovascular treatment between December 2015 and December 2017 at Department of Neurosurgery, the First Affiliated Hospital of Nanchang University. Among those, 8 cases were treated with stent-assisted coil embolization and 2 with stent embolization. We used DSA、TOF-MRA and HR-VWI at follow-up to identify the arterial stenosis and recurrence of aneurysm. Results Intravascular therapy was performed in 10 patients. Immediate postoperative angiography showed complete embolization in 7 cases and partial embolization in 3. There was no postoperative complication reported. The mean follow-up period was 6.8±5.5 months (range: 3-22 months). DSA results showed arteries with stenosis in 2 cases and no stenosis in the remaining 8. There were 6 parent arteries with stenosis and 4 parent arteries without stenosis in TOF-MRA. HR-VWI revealed 3 cases with stenosis and 7 cases without stenosis. There were 3 patients with recurrence in HR-VWI, TOF-MRA and DSA. HR-VWI and DSA were compared to evaluate the artery stenosis, and 2 cases were consistent and 1 case was not. However, there were 2 cases that were consistent and 4 cases that were not consistent by comparing between TOF-MRA and DSA results. The results of DSA, TOF-MRA and HR-VWI were consistent in evaluating the recurrence of dissected aneurysms. Two cases underwent the second endovascular therapy among 3 cases with recurrence and the other 1 case received conservative treatment. DSA and HR-VWI follow-up showed no stenosis or recurrence in the 2 cases. Conclusion HR-VWI may have high clinical application value in evaluation of recurrence of vertebrobasilar dissection aneurysms, which could be used as an optional method for follow-up after endovascular treatment of vertebrobasilar dissecting aneurysms. Key words: Aneurysm, dissecting; Vertebral artery; Basilar artery; Follow-up studies; Endorascular treatment; High-resolusion magnetic resonance vessel wall imaging