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Purpose <p>To evaluate the diagnostic capability and vessel visibility of Pointwise Encoding Time Reduction with Radial Acquisition MR angiography (PETRA-MRA) in a&#xa0;large cohort of patients with clipped intracranial aneurysms.</p> Materials and Methods <p>This retrospective single-center study included patients who underwent surgical clipping and follow-up MRI with PETRA-MRA sequence between January 2021 and August 2024. Two radiologists independently assessed PETRA-MRA and TOF-MRA for vessel visibility and recurrent aneurysms. Diagnostic performance was evaluated using DSA or CTA as reference standards.</p> Results <p>A&#xa0;total of 368 patients with 546 clipped intracranial aneurysms were evaluated (mean age, 64 ± 10.6 years; median follow-up, 8.9&#xa0;years). Twenty recurrent aneurysms (3.7%; incidence 0.61% per patient-year) were identified. In the DSA/CTA-verified subset, PETRA-MRA detected 18 of 20 recurrent aneurysms (sensitivity, 90.0%), whereas TOF-MRA detected 7 of 19&#xa0;(36.8%). PETRA-MRA demonstrated a&#xa0;specificity of 91.7%. For recurrent aneurysms smaller than 3 mm, PETRA-MRA detected more lesions than TOF-MRA (80.0% vs. 11.1%). Vessel visibility at the clipped aneurysm was higher in PETRA-MRA (72.3%) than TOF-MRA (12.5%). Interobserver agreement for PETRA-MRA was moderate (weighted κ = 0.51).</p> Conclusion <p>PETRA-MRA showed higher sensitivity and improved adjacent-vessel visualization compared with TOF-MRA in verified and strictly paired analyses. These findings suggest that PETRA-MRA may be a&#xa0;useful imaging tool for the postoperative surveillance of clipped intracranial aneurysms. Because reference-standard angiography was selectively performed, specificity, PPV, NPV, and accuracy should be interpreted as verified-subset estimates.</p>

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Clinical Feasibility of PETRA-MRA for Long-Term Surveillance of Clipped Intracranial Aneurysms: a Retrospective Single-Center Study in 546 Aneurysms

  • 期刊论文

  • 发表日期：

    2026年7月14日

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  • Hee Sang Oh,
  • Bio Joo,
  • Mina Park,
  • Sung Jun Ahn,
  • Kwon-Duk Seo,
  • Sang Kyu Park,
  • Sang Hyun Suh

摘要

Purpose

To evaluate the diagnostic capability and vessel visibility of Pointwise Encoding Time Reduction with Radial Acquisition MR angiography (PETRA-MRA) in a large cohort of patients with clipped intracranial aneurysms.

Materials and Methods

This retrospective single-center study included patients who underwent surgical clipping and follow-up MRI with PETRA-MRA sequence between January 2021 and August 2024. Two radiologists independently assessed PETRA-MRA and TOF-MRA for vessel visibility and recurrent aneurysms. Diagnostic performance was evaluated using DSA or CTA as reference standards.

Results

A total of 368 patients with 546 clipped intracranial aneurysms were evaluated (mean age, 64 ± 10.6 years; median follow-up, 8.9 years). Twenty recurrent aneurysms (3.7%; incidence 0.61% per patient-year) were identified. In the DSA/CTA-verified subset, PETRA-MRA detected 18 of 20 recurrent aneurysms (sensitivity, 90.0%), whereas TOF-MRA detected 7 of 19 (36.8%). PETRA-MRA demonstrated a specificity of 91.7%. For recurrent aneurysms smaller than 3 mm, PETRA-MRA detected more lesions than TOF-MRA (80.0% vs. 11.1%). Vessel visibility at the clipped aneurysm was higher in PETRA-MRA (72.3%) than TOF-MRA (12.5%). Interobserver agreement for PETRA-MRA was moderate (weighted κ = 0.51).

Conclusion

PETRA-MRA showed higher sensitivity and improved adjacent-vessel visualization compared with TOF-MRA in verified and strictly paired analyses. These findings suggest that PETRA-MRA may be a useful imaging tool for the postoperative surveillance of clipped intracranial aneurysms. Because reference-standard angiography was selectively performed, specificity, PPV, NPV, and accuracy should be interpreted as verified-subset estimates.