Aneurysm wall enhancement (AWE) post Gadolinium contrast on high-resolution black blood MRI has been studied as a marker of unstable intracranial aneurysms. However, a recent study showed slow flow could mimic AWE. This study evaluated four black blood sequences with high- and low-resolution fast-spin-echo (SPACE), with and without MSDE/DANTE blood suppression modules. In 30 unruptured saccular aneurysms, we found low-resolution SPACE significantly overestimated AWE (20/30 enhanced) compared to high-resolution SPACE (16 enhanced) and sequences with MSDE/DANTE (14 and 13 enhanced). High-resolution DANTE-SPACE has the best blood suppression and image quality, which is a preferred method for AWE assessment.
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