Abstract
Introduction: Arteriosclerosis in the intracranial internal carotid artery (iIC) must be evaluated during aneurysm neck clipping for internal carotid artery-posterior communicating artery aneurysm (IC-PC An), when we control the proximal artery to the aneurysm. Here, we investigated the usefulness of iIC by the MRI contrast-enhanced motion-sensitized driven equilibrium (CE-MSDE). Method: We enrolled 12 patients (mean age, 63.0±12.3 years; range, 32–78 years) who underwent neck clipping for IC-PC An from January 2019 to March 2023. Of them, 10 were unruptured cases and 2 were impending ruptured cases. The average size of the aneurysm was 7.2±2.2 mm, the average distance from the anterior clinoid process to the proximal neck of the aneurysm was 4.4 mm, and the average surgical time was 5 hours and 10 minutes. We performed preoperative computed tomography (CT) angiography, MRI, and CE-MSDE. The results were retrospectively compared and evaluated its usefulness.
Results: Six patients had atherosclerotic changes in iIC intraoperatively (50.0%); one (16.7%) had calcification on CT, and all six had positive findings on CE-MSDE on iIC. In the six patients (50.0%), no arteriosclerotic changes were observed in the iIC during surgery. Of them, one (16.7%) showed calcification on CT, and none were CE-MSDE-positive. The sensitivity and specificity of iIC for predicting arteriosclerosis were 16.7% and 83.3% for CT, whereas for CE-MSDE, both were 100%.
Conclusion: MRI CE-MSDE could be a predictor of atherosclerosis changes in iIC. When we consider the surgical strategies for IC-PC An, CE-MSDE should be confirmed preoperatively.
