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Journal of Computer Assisted Tomography:
doi: 10.1097/RCT.0b013e3181ecc265

Echocardiogram-Gated Computed Tomographic and Magnetic Resonance Angiographies for the Detection of Pulsatile Expansion at the Intracranial Arterial Bifurcation

Lee, Young-Jun MD*; Chung, Tae-Sub MD†; Rhim, Yoon-Chul PhD‡; Suh, Sang-Hyun MD†; Foo, Thomas K.F. PhD§

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Objective: To identify the pulsatile small vascular lesion by echocardiogram (ECG)-gated computed tomographic (CT) and magnetic resonance (MR) angiographies.

Methods: Seven patients who exhibited small evagination at the cerebral artery bifurcations on 3-dimensional (3D) time-of-flight MR angiogram were enrolled. They were examined by conventional/ECG-gated CT angiogram (n = 6) and ECG-gated MR angiogram (n = 5). Echocardiogram-gated MR angiogram was performed with 3D time of flight, triggered after each time window. From ECG-gated CT and MR angiograms, consecutive 10-phase images within a single cardiac cycle were obtained.

Results: The pulsatile change of evagination was demonstrated on both ECG-gated CT angiogram (5 of 6 patients) and ECG-gated MR angiogram (all 5 patients). Flattening of the evagination during the diastolic phase was observed in 4 of 6 ECG-gated CT angiograms and 3 of 5 ECG-gated MR angiograms. Of note was a patient with a tiny evagination (<2 × 1 mm); pulsatile change was demonstrated only by ECG-gated MR angiogram.

Conclusion: The pulsatile expansion of evagination at the cerebral artery bifurcation can be demonstrated on ECG-gated CT/MR angiograms.

© 2010 Lippincott Williams & Wilkins, Inc.



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