Evaluation of HOP-MRA for post-coil embolization assessment of cerebral aneurysms: a comparative study with 3D-TOF MRA

Abstract Purpose Hybrid of opposite contrast magnetic resonance angiography (HOP-MRA) is a technique that enhances the visualization of slow-flow vessels by subtracting the low-signal component of flow-sensitive black blood (FSBB) imaging from the high-signal component of 3D time-of-flight (TOF) MRA...

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Bibliographic Details
Main Author: Kouichi Asahi
Format: Article
Language:English
Published: SpringerOpen 2025-05-01
Series:The Egyptian Journal of Radiology and Nuclear Medicine
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Online Access:https://doi.org/10.1186/s43055-025-01482-5
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Summary:Abstract Purpose Hybrid of opposite contrast magnetic resonance angiography (HOP-MRA) is a technique that enhances the visualization of slow-flow vessels by subtracting the low-signal component of flow-sensitive black blood (FSBB) imaging from the high-signal component of 3D time-of-flight (TOF) MRA. This study evaluates the utility of HOP-MRA in assessing residual lumen and parent artery structure following cerebral aneurysm coil embolization, focusing on its relevance in neurovascular imaging. Methods A comparative analysis was conducted using both in vitro phantom models and in vivo patient data. A phantom model containing a coiled aneurysm was assessed with HOP-MRA and 3D-TOF MRA to evaluate susceptibility artifacts. Additionally, 12 patients with 13 coiled aneurysms underwent both imaging modalities. Aneurysm remnant and parent artery visualization were graded using a three-grade scale, and interobserver agreement was analyzed. Results Phantom experiments revealed increased susceptibility artifacts with HOP-MRA, particularly in the parent artery region. However, in vivo imaging demonstrated no significant difference in parent artery and aneurysm remnant visualization between HOP-MRA and 3D-TOF MRA (interobserver agreement: 96%). HOP-MRA provided more anatomically accurate depictions in select cases compared with digital subtraction angiography, particularly in small residual aneurysm remnants. Conclusion Despite susceptibility artifacts observed in vitro, HOP-MRA demonstrated comparable performance to 3D-TOF MRA in assessing post-embolization aneurysm remnants and adjacent vasculature. This suggests that HOP-MRA can be utilized as an alternative imaging technique, particularly in cases where slow-flow remnants are suspected, when appropriate parameters are applied.
ISSN:2090-4762