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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

Journal of Computer Assisted Tomography: November/December 2010 - Volume 34 - Issue 6 - pp 842-846
doi: 10.1097/RCT.0b013e3181ecc265
Neuroradiology

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.

From the *Hanyang University Hospital, Hanyang University College of Medicine; †Gangnam Severance Hospital, Yonsei University College of Medicine; ‡Yonsei University College of Mechanical Engineering, Seoul, Korea; and §GE Global Research, Niskayuna, NY.

Received for publication February 4, 2010; accepted June 11, 2010.

Reprints: Tae-Sub Chung, MD, Department of Diagnostic Radiology and the Research Institute of Radiological Science, College of Medicine, Yonsei University, Gangnam Severance Hospital, 146-92, Dokok-Dong, Gangnam-Ku, Seoul 135-270, Korea (e-mail: tschung@yuhs.ac).

The authors declare that they have no conflict of interest.

Copyright © 2010 Wolters Kluwer Health, Inc. All rights reserved.