Size Ratio Performance in Detecting Cerebral Aneurysm Rupture Status Is Insensitive to Small Vessel Removal
Size Ratio Performance in Detecting Cerebral Aneurysm Rupture Status Is Insensitive to Small Vessel Removal
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DOI：
10.1227/neu.0b013e318282a513
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发表时间：
2013-04-01
期刊：
影响因子：
4.8
通讯作者：
Malek, Adel M.
中科院分区：
文献类型：
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作者：
Lauric, Alexandra;Baharoglu, Merih I.;Malek, Adel M.
背景技术背景：侧壁（SW）与分叉（BIF）动脉瘤的尺寸比（SR）的可变定义引起了对包含小分支的病变（如颈动脉眼或后交通部位）的混淆。这些动脉瘤被许多临床医生认为是SW，但SR方法将其分类为BIF。目的：评价忽略小血管和SW与严格BIF标记对具有小分支的边缘动脉瘤SR破裂动脉瘤检测性能的影响，并使基于SR的标记与临床SW/BIF分类相一致。方法：134个连续动脉瘤（60个破裂）的导管旋转血管造影数据集在三维中自动测量。将严格的BIF标记应用于临床标记的动脉瘤，其中21个动脉瘤将标签从SW转换为BIF。评价载瘤血管尺寸时考虑和忽略小血管。SR相应地定义为动脉瘤和载瘤血管尺寸之间的比值。单变量和多变量统计确定了显着的功能。相关系数的平方（R-2）被报道为双变量分析的替代SR calculation.Results：无论SW/BIF标记方法，SR是同样显着的判别动脉瘤破裂状态（P < .001）。双变量分析的替代SR有很高的相关性R-2 = 0.94的整个数据集，和R-2 = 0.98的21个交界性动脉瘤。结论：忽略小分支从SR计算保持破裂状态检测性能，同时降低后处理的复杂性和消除标记的歧义。这些血管附近的动脉瘤可视为SW，用于形态测定分析。当使用SR进行破裂风险评价时，使用临床SW/BIF标签是合理的。
BACKGROUND: The variable definition of size ratio (SR) for sidewall (SW) vs bifurcation (BIF) aneurysms raises confusion for lesions harboring small branches, such as carotid ophthalmic or posterior communicating locations. These aneurysms are considered SW by many clinicians, but SR methodology classifies them as BIF.OBJECTIVE: To evaluate the effect of ignoring small vessels and SW vs stringent BIF labeling on SR ruptured aneurysm detection performance in borderline aneurysms with small branches, and to reconcile SR-based labeling with clinical SW/BIF classification.METHODS: Catheter rotational angiographic datasets of 134 consecutive aneurysms (60 ruptured) were automatically measured in 3-dimensional. Stringent BIF labeling was applied to clinically labeled aneurysms, with 21 aneurysms switching label from SW to BIF. Parent vessel size was evaluated both taking into account, and ignoring, small vessels. SR was defined accordingly as the ratio between aneurysm and parent vessel sizes. Univariate and multivariate statistics identified significant features. The square of the correlation coefficient (R-2) was reported for bivariate analysis of alternative SR calculations.RESULTS: Regardless of SW/BIF labeling method, SR was equally significant in discriminating aneurysm ruptured status (P < .001). Bivariate analysis of alternative SR had a high correlation of R-2 = 0.94 on the whole dataset, and R-2 = 0.98 on the 21 borderline aneurysms.CONCLUSION: Ignoring small branches from SR calculation maintains rupture status detection performance, while reducing postprocessing complexity and removing labeling ambiguity. Aneurysms adjacent to these vessels can be considered SW for morphometric analysis. It is reasonable to use the clinical SW/BIF labeling when using SR for rupture risk evaluation.