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Meta-analysis on Diagnostic Accuracy of MR Angiography in the Follow-Up of Residual Intracranial Aneurysms Treated with Guglielmi Detachable Coils.

  • Weng, Hsu Huei
  • Jao, Shaner Yeun
  • Yang, Chun Yuh
  • Tsai, Yuan Hsiung
Published Article
Interventional neuroradiology : journal of peritherapeutic neuroradiology, surgical procedures and related neurosciences
Publication Date
Nov 11, 2008
14 Suppl 2
PMID: 20557802


Patients with intracranial aneurysm after coiling with Guglielmi detachable coils (GDC) require imaging follow-up. The accuracy of noninvasive magnetic resonance angiography (MRA) techniques including time-of-flight (TOF) and contrast-enhancement (CE) have been compared with the gold standard digital subtraction angiography (DSA).We systematically reviewed the diagnostic accuracy of these imaging methods in follow-up study of patients with residual intracranial aneurysms after GDC treatment. The authors used MEDLINE, bibliographies, review articles, textbooks, and expert opinion to retrieve English- and non-English-language articles published from 1966 to December 2007. Sixteen suitable MRA original articles (14 TOFMRA and six CE-MRA) with comparison to DSA have met the inclusion criteria. TOF-MRA had a pooled sensitivity of 90% (95% CI, 79% to 95%), a specificity of 95% (95% CI, 88% to 98%), and a diagnostic odds ratio (DOR) of 168.4 (95% CI, 60.3 to 470.3). CE-MRA had an overall sensitivity of 92% (95% CI, 79% to 97%), a specificity of 96% (95% CI, 91% to 98%), and a DOR of 280.4 (95% CI, 64.8 to 1212.6). The areas under two summary ROC curves of TOF-MRA and CE-MRA were 0.97 (95% CI, 0.96 to 0.99) and 0.98 (95% CI, 0.96 to 0.99), respectively. Compared with DS angiography, both TOF-MRA and CE-MRA can accurately depict the residual aneurysm. The diagnostic accuracy of TOF-MRA and CE-MRA tests offer comparable and equal results and may obviate the invasive DS angiography.

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