Value of magnetic resonance angiography for the detection of intracranial aneurysms in autosomal dominant polycystic kidney disease.
Value of magnetic resonance angiography for the detection of intracranial aneurysms in autosomal dominant polycystic kidney disease.
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发表时间：
1993-06
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通讯作者：
John Huston;Vicente E. Torres;P. Sulivan;K. Offord;D. Wiebers
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作者：
John Huston;Vicente E. Torres;P. Sulivan;K. Offord;D. Wiebers
颅内动脉瘤与常染色体显性多囊肾病 (ADPKD) 的关联、动脉瘤破裂的 30 天死亡率超过 50%、未破裂动脉瘤手术修复的有效性、手术风险低以及用于检测的无创成像技术的发展，这些因素促使医生考虑筛查 ADPKD 患者是否存在未破裂颅内动脉瘤的价值。高分辨率计算机断层扫描和磁共振成像诊断颅内小动脉瘤的敏感性和特异性令人失望。为了确定磁共振血管造影 (MRA) 的价值，对 85 名无颅内动脉瘤相关症状的 ADPKD 患者和 2 名出现蛛网膜下腔出血或疑似动脉瘤漏的 ADPKD 患者进行了研究。 MRA 是通过多序列血管包（GE 医疗系统）进行的，采用三维飞行时间和三维相位对比技术，并生成后处理最大强度投影图像，以消除血管重叠的问题。 27 例有颅内动脉瘤或蛛网膜下腔出血家族史的患者中，有 6 例（22%）检测到无症状颅内动脉瘤，56 例无颅内动脉瘤或蛛网膜下腔出血家族史的患者中，有 3 例（5%）检测到无症状颅内动脉瘤（P = 0.02，2 例患者信息缺失），以及 2 例有症状的动脉瘤患者。逐步逻辑回归分析表明，颅内动脉瘤或蛛网膜下腔出血的家族史与颅内动脉瘤的存在独立相关。所有动脉瘤的直径均 < 或 = 6.5 毫米。（摘要截短为 250 字）
The association of intracranial aneurysms with autosomal dominant polycystic kidney disease (ADPKD), the 30-day mortality rate exceeding 50% for aneurysmal rupture, the effectiveness of surgical repair of unruptured aneurysms with a low surgical risk, and the development of noninvasive imaging techniques for their detection have led physicians to consider the value of screening patients with ADPKD for unruptured intracranial aneurysms. The sensitivity and specificity of high-resolution computed tomography and magnetic resonance imaging for the diagnosis of small intracranial aneurysms have been disappointing. To determine the value of magnetic resonance angiography (MRA), 85 patients with ADPKD without symptoms related to an intracranial aneurysm and 2 patients with ADPKD presenting with a subarachnoid hemorrhage or a suspected aneurysmal leak were studied. MRA was performed with the Multisequence Vascular Package (GE Medical Systems) with use of three-dimensional time-of-flight and three-dimensional phase-contrast techniques, and postprocessing maximum intensity projection images were generated to eliminate the problem of overlapping vessels. Asymptomatic intracranial aneurysms were detected in 6 (22%) of 27 patients with and 3 (5%) of 56 patients without a family history of intracranial aneurysm or subarachnoid hemorrhage (P = 0.02, information missing in 2 patients) and in the 2 patients who presented with a symptomatic aneurysm. A stepwise logistic regression analysis indicated that a family history of intracranial aneurysm or subarachnoid hemorrhage was independently associated with the presence of intracranial aneurysms. All of the aneurysms were < or = 6.5 mm in diameter.(ABSTRACT TRUNCATED AT 250 WORDS)