Geometric parameters on MRA source images to differentiate small Proximal Posterior communicating artery aneurysms from Infundibular dilation
Geometric parameters on MRA source images to differentiate small Proximal Posterior communicating artery aneurysms from Infundibular dilation
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DOI：
10.1111/jon.12846
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发表时间：
2021-04-13
影响因子：
2.4
通讯作者：
Cho, Byung-Moon
中科院分区：
文献类型：
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作者：
Kim, Yun Ji;Yoon, Dae Young;Cho, Byung-Moon
背景与目的：评价磁共振血管造影（MRA）在颈内动脉-后交通动脉小动脉瘤与漏斗部扩张（IDS）鉴别诊断中的准确性（ICA-PComA）连接，方法回顾性分析83例伊卡-10动脉瘤的MRA轴向源图像，76例患者同时接受MRA和数字减影血管造影（DSA）/三维旋转血管造影（3D）检查。以DSA/3DSA判读结果为参考标准，计算MRA对动脉瘤和ID的鉴别诊断性能。此外，长轴直径、短轴直径、长轴直径/短轴直径（L/S）比值和病变角度比较动脉瘤和ID在MRA源图像上测量的病变长轴相对于x轴的角度。结果敏感性，特异性，MRA对鉴别动脉瘤与ID的准确率为74.4%（57.9-87.0%）至76.9%（60.7-88.9%）、93.2%（81.3-98.6%）至95.5%（84.5-99.4%）和85.5%（76.1-92.3%）。动脉瘤和ID在MRA轴向源图像上的长轴直径（P <0.001）、短轴直径（P <0.001）、L/S比（P <0.05）和病变角度（P <0.001）存在显著差异。病变角度具有区分动脉瘤与ID的最高区分能力（曲线下面积= 0.966 [0.902 - 0.994]）。病变角度>60 °诊断动脉瘤的敏感性为89.7%（75.8-97.1%），特异性为100%（92.0-100.0%）。此外，MRA轴向源图像上的几何参数可以在它们的区分中提供附加值。
Background and Purpose We aimed to assess the accuracy of magnetic resonance angiography (MRA) in the differentiation of small aneurysms versus infundibular dilations (IDs) at the internal carotid artery-posterior communicating artery (ICA-PComA) junction, emphasizing the role of MRA axial source images.Methods This retrospective study consisted of 83 focal arterial protrusions at ICA-PComA junction in 76 patients who underwent both MRA and digital subtraction angiography (DSA)/3-dimensional rotational angiography (3DRA). The diagnostic performance of MRA for differential diagnosis of aneurysm from ID was calculated using DSA/3DRA interpretation as the standard of reference. In addition, long-axis diameter, short-axis diameter, long-axis diameter/short-axis diameter (L/S) ratio, and angle of lesion (angle of the long-axis of lesion with respect to the x-axis) measured on MRA source images were compared between aneurysms and IDs.Results Sensitivity, specificity, and accuracy of MRA for distinguishing aneurysms from IDs were 74.4% (57.9-87.0%) to 76.9% (60.7-88.9%), 93.2% (81.3-98.6%) to 95.5% (84.5-99.4%), and 85.5% (76.1-92.3%), respectively. Significant differences were found for the long-axis diameter (P < .001), short-axis diameter (P < .001), L/S ratio (P < .05), and angle of the lesion (P < .001) on MRA axial source images between aneurysms and IDs. The angle of the lesion had the highest discriminatory ability (area under the curve = .966 [.902-.994]) to differentiate aneurysms from IDs. An angle of lesion >60 degrees was 89.7% (75.8-97.1%) sensitive and 100% (92.0-100.0%) specific for diagnosis of aneurysm.Conclusions MRA is a useful imaging modality for distinguishing between aneurysm and ID at the ICA-PComA junction. Furthermore, geometric parameters on MRA axial source images can provide added value in their differentiation.