Usefulness of contrast-enhanced 3D MR angiography and contrast-enhanced 3D T1 sequence for detecting intracranial infectious aneurysms in infectious endocarditis.

Abstract Objectives To assess the diagnostic value of contrast-enhanced MRA (CE MRA) and CE 3D-T1 for identifying intracranial infectious aneurysms (IIAs) in infective endocarditis (IE) with digital substraction angiography (DSA) as reference. Methods Twenty-one IE patients (14 males; mean age: 53 years) with 30 IIAs, diameter ranging 1.5 –15mm ( Results The sensitivity, specificity, positive and negative predictive values and accuracy of IIA detection were respectively: 80%, 100%, 100%, 82.3%, 90% for CE MRA and 86.7%, 100%, 100%, 88.2%, 93.3% for CE 3D T1 compared to DSA. No significant difference was observed between CE MRA and CE 3D-T1 for accuracy and quality of visualization. All IIAs of ≥3mm in diameter (16/30; 53.%) were identified by both sequences, which were also able to detect IIAs ≤ 3mm (n=14/30, 46.7%). False negatives were observed with both sequences for 4 IIAs of Intra and inter-observer agreement was were good and similar with both methods. Conclusion Both CE MRA and CE 3D-T1 have good accuracy compared to DSA detection and characterization of IIAs. CE 3D-T1 also evaluates anatomical relationships of IIAs, which could help DSA location and endovascular treatment.