Occult intracranial aneurysms in polycystic kidney disease: screening with MR angiography.

Abstract

To estimate the prevalence, location, and type of cerebral aneurysms in patients with adult polycystic kidney disease (PCKD) and identify associated risk factors. Ninety-three patients with PCKD were screened for aneurysms with spin-echo parenchymal magnetic resonance (MR) imaging and three-dimensional time-of-flight MR angiography. Prevalence was estimated with the calculated proportions of patients who had aneurysms, adjusted for reported sensitivity and specificity of MR angiography. Thirteen aneurysms, found in 10 patients, were 7 mm or smaller in largest dimension; 11 of these aneurysms were saccular. Intra- and interobserver variabilities were 96%-98%. Conventional arteriograms, obtained in six patients, helped confirm the MR angiographic findings. The best estimates of prevalence of aneurysms were 11.7% in the study group (n = 93) and 25.8% in patients with a family history of aneurysms (n = 6). The prevalence of aneurysms in the study group was greater than in the general population. MR angiography is useful in screening for cerebral aneurysms.