Does Aneurysmal Wall Enhancement on Vessel Wall MRI Help to Distinguish Stable From Unstable Intracranial Aneurysms?
Does Aneurysmal Wall Enhancement on Vessel Wall MRI Help to Distinguish Stable From Unstable Intracranial Aneurysms?
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DOI：
10.1161/strokeaha.114.006626
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发表时间：
2014-12-01
期刊：
影响因子：
8.3
通讯作者：
Naggara, Olivier
中科院分区：
文献类型：
--
作者：
Edjlali, Myriam;Gentric, Jean-Christophe;Naggara, Olivier
背景与目的：颅内炎性动脉疾病的血管壁MRI显示动脉壁增强。我们假设环动脉瘤壁增强（CAWE）可能是动脉瘤壁炎症的间接标志，因此，在不稳定（破裂、有症状或正在发生形态改变）的颅内动脉瘤中，CAWE比稳定（偶然发生和未进化）的颅内动脉瘤更常见。方法：对稳定性或不稳定性颅内动脉瘤患者进行前瞻性血管壁MRI检查。两个读取器必须独立地确定CAWE是否存在。结果：我们纳入了87例患者，其中包含108个动脉瘤。CAWE的解读者和解读者一致性非常好（kappa=0.85, 95%置信区间分别为0.75-0.95和0.90,95%置信区间分别为0.83-0.98）。不稳定动脉瘤的CAWE发生率明显高于稳定动脉瘤（27/ 31,87%比22/ 77,28.5%）
Background and Purpose-Arterial wall enhancement on vessel wall MRI was described in intracranial inflammatory arterial disease. We hypothesized that circumferential aneurysmal wall enhancement (CAWE) could be an indirect marker of aneurysmal wall inflammation and, therefore, would be more frequent in unstable (ruptured, symptomatic, or undergoing morphological modification) than in stable (incidental and nonevolving) intracranial aneurysms.Methods-We prospectively performed vessel wall MRI in patients with stable or unstable intracranial aneurysms. Two readers independently had to determine whether a CAWE was present.Results-We included 87 patients harboring 108 aneurysms. Interreader and intrareader agreement for CAWE was excellent (kappa=0.85; 95% confidence interval, 0.75-0.95 and kappa=0.90; 95% confidence interval, 0.83-0.98, respectively). A CAWE was significantly more frequently seen in unstable than in stable aneurysms (27/31, 87% versus 22/77, 28.5%, respectively; P