MRA volume rendering for surgical planning of unruptured intracranial cerebral aneurysms

A volume rendering (VR) three-dimensional reconstruction method was applied to magnetic resonance angiography (MRA), to investigate its usefulness for surgical planning of unruptured cerebral aneurysms (ANs). Twelve cases with anterior communicating artery (Acom) ANs and 16 cases with middle cerebral artery (MCA) ANs underwent MRA VR, preoperatively. There were 10 male and 18 female patients, whose ages were ranged from 37 to 73 (mean 58) years old. Appearance of ANs and surrounding vascular structures on MRA VR was compared with that on maximum intensity projection (MIP) image, three-dimensional digital subtraction angiogram (3D-DSA), and intraoperative findings. In all cases, MRA VR delineated aneurysms more clearly compared to MIP. In MCA ANs, MRA VR provided enough information for surgical planning, compatible with 3D-DSA. In Acom ANs, MRA VR delineated bilateral A1, A2 and Acorn complex simultaneously without temporary vascular occlusion. MRA VR may have a complementary role in preoperative evaluation of unruptured ANs with other modalities such as 3D-DSA. (author)