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Research ArticleExtracranial Vascular

Gadolinium Enhancement of the Aneurysm Wall in Extracranial Carotid Artery Aneurysms

C.J.H.C.M. van Laarhoven, M.L. Rots, V.E.C. Pourier, N.K.N. Jorritsma, T. Leiner, J. Hendrikse, M.D.I. Vergouwen and G.J. de Borst
American Journal of Neuroradiology March 2020, 41 (3) 501-507; DOI: https://doi.org/10.3174/ajnr.A6442
C.J.H.C.M. van Laarhoven
aFrom the Departments of Vascular Surgery (C.J.H.C.M.v.L., M.L.R., V.E.C.P., N.K.N.J., G.J.d.B.)
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  • ORCID record for C.J.H.C.M. van Laarhoven
M.L. Rots
aFrom the Departments of Vascular Surgery (C.J.H.C.M.v.L., M.L.R., V.E.C.P., N.K.N.J., G.J.d.B.)
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V.E.C. Pourier
aFrom the Departments of Vascular Surgery (C.J.H.C.M.v.L., M.L.R., V.E.C.P., N.K.N.J., G.J.d.B.)
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N.K.N. Jorritsma
aFrom the Departments of Vascular Surgery (C.J.H.C.M.v.L., M.L.R., V.E.C.P., N.K.N.J., G.J.d.B.)
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T. Leiner
bRadiology (T.L., J.H.)
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J. Hendrikse
bRadiology (T.L., J.H.)
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M.D.I. Vergouwen
cUMC Utrecht Brain Center (M.D.I.V.), Department of Neurology and Neurosurgery, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands.
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G.J. de Borst
aFrom the Departments of Vascular Surgery (C.J.H.C.M.v.L., M.L.R., V.E.C.P., N.K.N.J., G.J.d.B.)
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    Fig 1.

    Schematic examples of diameter measurements of ECAAs, perpendicular to the nonaffected vessel. Left: fusiform ECAA length × width. Right: saccular ECAA length × width × neck (round arrow).

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    Fig 2.

    Examples of aneurysm wall enhancement (solid arrow) on 3T MR imaging with aneurysm wall imaging on the transaxial plane. B, D, F, and H, The sequence after administration of gadolinium. A and B, A 66-year-old woman with a 11.0- mm saccular left internal carotid artery aneurysm without enhancement (dashed arrow). C and D, A 54-year-old man with a 9.0-mm saccular right internal carotid artery aneurysm without enhancement (dashed arrow). E and F, A 51-year-old woman with a 7.5-mm saccular left internal carotid artery aneurysm with aneurysm enhancement (solid arrow). G and H, A 59-year-old woman with a 10.0-mm fusiform left internal carotid artery aneurysm with enhancement (solid arrow). The asterisk indicates the parent ICA; e, branches of the external carotid artery; v, internal jugular vein.

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    Fig 3.

    Bland-Altman plot of interobserver agreement. The solid line in the middle represents the mean difference of the diameter measurements between the 2 observers; the dashed line represents the upper and lower limits of agreement (mean difference ± 1.96 × SD).

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    Fig 4.

    Overview baseline 3T Gd-enhanced MR imaging of 66-year-old woman with a saccular ECAA of the right internal carotid artery. At baseline, enhancement of the aneurysm wall was observed after contrast administration, indicated by the white arrows. T2 FLAIR and T2 TSE show both periventricular and deep white matter lesions and Fazekas 3 and multiple bilateral lacunar infarctions. adm indicates contrast administration.

Tables

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  • Aneurysm size for aneurysms with and without gadolinium enhancement


    No Gadolinium Enhancement (n = 4)Gadolinium Enhancement (n = 12)P
    Length baseline median (range)10.75 (6.5–46.0)14.5 (7.00–66.5).316
    Width baseline median (range)10.5 (9.0–41.0)11.5 (5.5 − 38.5).953
    Neck baselinea median (range)9.5 (8.0–11.0)12.0 (3.5–22.0).482
    Growth (length) median (range)1.0 (−1.0–4.0)0.5 (−0.5–4.5)>.999
    Growth (width) median (range)1.0 (−1.0–4.0)0.5 (−0.5–4.5)>.999
    Growth (neck)a median (range)0.0 (−1.0–0.5)2.0 (0.5–3.0).012b
    Growth (any direction ≥2 mm) (No.) (%)2 (50)2 (16.7).245
    • ↵a Only patients with saccular aneurysms.

    • ↵b P < .05.

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American Journal of Neuroradiology: 41 (3)
American Journal of Neuroradiology
Vol. 41, Issue 3
1 Mar 2020
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Cite this article
C.J.H.C.M. van Laarhoven, M.L. Rots, V.E.C. Pourier, N.K.N. Jorritsma, T. Leiner, J. Hendrikse, M.D.I. Vergouwen, G.J. de Borst
Gadolinium Enhancement of the Aneurysm Wall in Extracranial Carotid Artery Aneurysms
American Journal of Neuroradiology Mar 2020, 41 (3) 501-507; DOI: 10.3174/ajnr.A6442

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Gadolinium Enhancement of the Aneurysm Wall in Extracranial Carotid Artery Aneurysms
C.J.H.C.M. van Laarhoven, M.L. Rots, V.E.C. Pourier, N.K.N. Jorritsma, T. Leiner, J. Hendrikse, M.D.I. Vergouwen, G.J. de Borst
American Journal of Neuroradiology Mar 2020, 41 (3) 501-507; DOI: 10.3174/ajnr.A6442
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