Blood flow mimicking aneurysmal wall enhancement: A diagnostic pitfall of vessel wall MRI using the postcontrast 3D turbo spin-echo MR imaging sequence

Abstract

Our aim was to compare the detectability of aneurysmal wall enhancement in unruptured intracranial aneurysms between conventional and motion-sensitized driven equilibrium–prepared postcontrast 3D T1-weighted TSE sequences (sampling perfection with applicationoptimized contrasts by using different flip angle evolution, SPACE). Twenty-two patients with 30 unruptured intracranial aneurysms were scanned at 3T. Aneurysmal wall enhancement was more significantly detected using conventional compared with motion-sensitized driven equilibrium–prepared SPACE sequences (10/30 versus 2/30, P .0001). Contrast-to-noise ratio measurements did not differ between conventional and motion-sensitized driven equilibrium–prepared sequences (P .51). Flowing blood can mimic aneurysmal wall enhancement using conventional SPACE sequences with potential implications for patient care.