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

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.