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Should follow-up imaging for unruptured intracranial aneurysms include MRA head and MRI brain to evaluate for arterial wall enhancement?

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Mednet MemberInvited Expert
Neurology · HCA Houston Healthcare
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I prefer CTA to assess asymptomatic intracranial aneurysms if there are no concerning morphological features (e.g., daughter-sac, bi-lobed, or dysplastic/irregular shape) and if the size is less than 5 mm (although size/rupture risk can vary depending on the location of the aneurysm). CTA is easier to obtain and less cumbersome than MR imaging, with fewer chances for motion artifact due to its shorter scan time. While assessing for wall enhancement is a useful feature via MRI, it's only one aspe...

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