Differential Subsampling with Cartesian Ordering–MRA for Classifying Residual Treated Aneurysms

BACKGROUND AND PURPOSE: Differential Subsampling with Cartesian Ordering (DISCO), an ultrafast high-spatial-resolution head MRA, has been introduced. We aimed to determine the diagnostic performance of DISCO-MRA in grading residual aneurysm in comparison with TOF-MRA in patients with treated intracranial aneurysms. MATERIALS AND METHODS: Patients with endovascular treatment and having undergone DISCO-MRA, TOF-MRA, and DSA were included for review. The voxel size and acquisition time were 0.75 × 0.75 × 1 mm^3/6 seconds for DISCO-MRA and 0.6 × 0.6 × 1 mm^3/6 minutes for TOF-MRA. Residual aneurysms were determined using the Modified Raymond-Roy Classification on TOF-MRA and DISCO-MRA by 2 neuroradiologists independently and were compared against DSA as the reference standard. Statistical analysis was performed using the k statistic and the x ² test. RESULTS: Sixty-eight treated intracranial aneurysms were included. The intermodality agreement was k = 0.82 (95% CI, 0.67–0.97) between DISCO and DSA and 0.44 (95% CI, 0.28–0.61) between TOF and DSA. Modified Raymond-Roy Classification scores matched DSA scores in 60/68 cases (88%; x ² = 144.4, P, .001 for DISCO and 46/68 cases (68%; x ² = 65.0, P, .001) for TOF. The diagnostic accuracy for the detection of aneurysm remnants was higher for DISCO (0.96; 95% CI, 0.88–0.99) than for TOF (0.79; 95% CI, 0.68–0.88). CONCLUSIONS: In patients with endovascularly treated intracranial aneurysms, DISCO-MRA provides superior diagnostic performance in comparison with TOF-MRA in delineating residual aneurysms in a fraction of the time.