Unruptured intracranial aneurysms conservatively followed with serial CT angiography: could morphology and growth predict rupture?
Unruptured intracranial aneurysms conservatively followed with serial CT angiography: could morphology and growth predict rupture?
复制标题
DOI：
10.1136/neurintsurg-2013-010944
复制
发表时间：
2014-12-01
影响因子：
4.8
通讯作者：
Schaefer, Pamela W.
中科院分区：
文献类型：
--
作者：
Mehan, William A., Jr.;Romero, Javier M.;Schaefer, Pamela W.
背景和目的尽管有几项具有里程碑意义的研究，但未破裂颅内动脉瘤（UIA）的自然史仍不确定。我们的目的是确定或确认UIA破裂的预测因素，保守地观察与串行CT血管造影（CTA）在北美patient population.Methods我们进行了回顾性分析，UIA患者的后续序列CTA研究，从1999年至2010年。根据官方放射学报告和CTA图像对每个动脉瘤的以下特征进行分类：最大直径、随访研究之间的生长、位置、多样性、壁钙化、腔内血栓和形态。对动脉瘤破裂的潜在独立危险因素进行单因素logistic回归分析。结果152例共180例UIA患者至少进行了2次CTA检查，其中152例患者的UIA发生率为100%。在CTA随访期间，6名不同患者的6个动脉瘤破裂，总破裂率为3.3%，年破裂率为0.97%。所有破裂动脉瘤均为9mm。在单变量分析中，动脉瘤破裂的统计学显著预测因素为动脉瘤大小（p=0.003）、动脉瘤生长（p
Background and purpose Despite several landmark studies, the natural history of unruptured intracranial aneurysms (UIA) remains uncertain. Our aim was to identify or confirm factors predictive of rupture of UIA being observed conservatively with serial CT angiography (CTA) in a North American patient population.Methods We performed a retrospective review of patients with UIA being followed with serial CTA studies from 1999 to 2010. The following features for each aneurysm were cataloged from the official radiologic reports and CTA images: maximum diameter, growth between follow-up studies, location, multiplicity, wall calcification, intraluminal thrombus and morphology. Univariate logistic regression analysis of the potential independent risk factors for aneurysm rupture was performed. Statistically significant risk factors from the univariate analysis were then entered into a multivariate logistic regression analysis.Results 152 patients with a total of 180 UIA had at least two CTA studies. Six aneurysms in six different patients ruptured during the CTA follow-up period for an overall rupture rate of 3.3% and an annual rupture rate of 0.97%. All ruptured aneurysms were 9mm. In the univariate analysis, the statistically significant predictors of aneurysm rupture were aneurysm size (p=0.003), aneurysm growth (p