General discussion 149 No?? = Coiling not suitable but with uncertainty about this unsuitability. Figure 1. Diagnostic flow chart for patients presenting with a SAH MRA for treatment planning If MRA were to perform better than CTA in determining the coilability of an aneurysm this would be a reason to use MRA in the work-up of patients presenting with aneurysmal SAH. Despite a few promising results reported in the studies reviewed in Chapter 1,36-40 in our study CEMRA at 1.5T yielded no better results than CTA in the assessment of coilability of aneurysms (see Chapter 3). However, advances have been made in both CT and MR imaging techniques since this study was performed. MRA systems operating at 3T have become widely available, but the advantage of imaging at 3T over 1.5T is not clear; very few direct comparisons are available in this patient population.41 Current data implies that the main advantage of 3T MRA lies in the detection of very small (<3mm) aneurysms, and not so much in the characterization of aneurysms as suitable or unsuitable for endovascular coiling.37,42 The evolution of CT technology, on the other hand, from the 2- and 4-detector-row scanners used in our study to 16- , 64- or
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