110 Chapter 6 Figure 3. 63 year old female with coiled 6x10mm right posterior communicating artery aneurysm. Initial occlusion was 100%. a. DSA at 6 months shows a recanalization at the neck, R&R class 2. b. MRA at 6 months: Observer 1 considered this a recanalization R&R class 3, while observer 2 thought that this was no recanalization at all. Figure 4. 55 year old female with coiled 3mm small left posterior inferior cerebellar artery aneurysm. Initially complete occlusion. a. Follow-up DSA at 24 months shows small recanalization in the neck, R&R class 2. b. MRA at 24 months: observer 1 did not see a recanalization, while observer 2 considered this a R&R class 3 recanalization. Assessing change in aneurysm occlusion compared with initial post coiling DSA could give additional information for cases that leave doubt whether re-treatment is indicated or not. Comparing MRA with DSA images, however, is less accurate, which is probably one of the reasons the test characteristics of this comparison are lower than those of the recanalization assessment.
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