CT angiography for one-year follow-up of intracranial aneurysms treated with the WEB device: Utility in evaluating aneurysm occlusion and WEB compression at one year
CT angiography for one-year follow-up of intracranial aneurysms treated with the WEB device: Utility in evaluating aneurysm occlusion and WEB compression at one year
复制标题
DOI：
10.1016/j.neurad.2018.02.010
复制
发表时间：
2018-10-01
影响因子：
3.5
通讯作者：
Gauvrit, Jean-Yves
中科院分区：
文献类型：
--
作者：
Raoult, Helene;Eugene, Francois;Gauvrit, Jean-Yves
背景和目的。- WEB是一种创新的血流中断装置，用于快速扩展适应症的脑动脉瘤栓塞。我们的目的是评估ct血管造影（CTA）在1年随访中对经血管造影治疗的动脉瘤的诊断性能。材料和方法。- 2014年4月至2016年5月，该研究前瞻性纳入在我院接受WEB治疗的患者，并在24小时内进行CTA随访，1年后进行CTA、飞行时间磁共振血管造影（TOF MRA）和数字减影血管造影（DSA）随访。基于置信度指数、伪影和WEB形状描述来评估成像数据的诊断质量。影像学诊断使用3个标准评估1年：动脉瘤闭塞状态和恶化，WEB形状压缩。通过计算kappa值来确定观察者间和多式联运的一致性。该研究最终纳入16例患者（9名女性，平均年龄53±7.6岁）。CTA质量置信度评分为2/2，伪影评分为0.4/2，WEB形状描述评分为1.9/2，后两个标准优于TOF MRA。93.7%的患者动脉瘤闭塞足够，CTA表现出良好的观察者间再现性，与DSA在4级量表上的一致性（kappa = 1.00），而TOF MRA表现出良好的再现性（kappa = 0.76），与DSA的一致性（kappa = 0.69）。CTA还发现动脉瘤闭塞恶化（43.7%）和WEB压迫（81.2%），与DSA非常吻合（kappa = 0.85和1.00）。CTA是一种可重复且可靠的技术，可用于治疗动脉瘤的随访。(C) 2018 Elsevier Masson SAS。版权所有。
Background and purpose. - The WEB is an innovative flow disruption device for cerebral aneurysm embolization with rapidly expanding indications. Our purpose was to evaluate the diagnostic performance of computed tomography angiography (CTA) at 1-year follow-up of aneurysms treated with the WEB.Materials and methods. - Between April 2014 and May 2016, the study prospectively included patients treated with the WEB at our institution, and followed up within 24 hours by CTA and at 1 year by CTA, time-of-flight magnetic resonance angiography (TOF MRA) and digital subtraction angiography (DSA). The diagnostic quality of imaging data was assessed based on the confidence index, artifacts, and WEB shape depiction. The imaging diagnostic performance was assessed using 3 criteria at 1 year: aneurysm occlusion status and worsening, and WEB shape compression. lnterobserver and intermodality agreement was determined by calculating kappa values.Results. - The study ultimately included 16 patients (9 women, mean age 53 +/- 7.6 years). CTA quality confidence was scored as 2/2, artifacts 0.4/2 and WEB shape depiction 1.9/2, superior to TOF MRA for the latter two criteria. Aneurysm occlusion was adequate in 93.7% of patients, with CTA showing excellent interobserver reproducibility and agreement with DSA on a 4-grade scale (kappa = 1.00), while TOF MRA yielded good reproducibility (kappa = 0.76) and agreement with DSA (kappa = 0.69). CTA also identified aneurysm occlusion worsening (43.7%) and WEB compression (81.2%) in excellent agreement with DSA (kappa = 0.85 and 1.00).Conclusions. - CTA is a reproducible and reliable technique for the follow-up of aneurysms treated with the WEB device. (C) 2018 Elsevier Masson SAS. All rights reserved.