Relationship Between Aneurysm Wall Enhancement in Vessel Wall Magnetic Resonance Imaging and Rupture Risk of Unruptured Intracranial Aneurysms
Relationship Between Aneurysm Wall Enhancement in Vessel Wall Magnetic Resonance Imaging and Rupture Risk of Unruptured Intracranial Aneurysms
复制标题
血管壁磁共振成像中动脉瘤壁增强与未破裂颅内动脉瘤破裂风险之间的关系。
DOI：
10.1093/neuros/nyy310
复制
发表时间：
2019-06-01
期刊：
影响因子：
4.8
通讯作者：
Liu, Jianmin
中科院分区：
文献类型：
--
作者：
Lv, Nan;Karmonik, Christof;Liu, Jianmin
背景
未破裂的颅内动脉瘤(IAS)的破裂风险评估仍然具有挑战性。血管壁磁共振成像(VW-MRI)上的动脉瘤壁增强(AWE)被认为是血管壁炎症的潜在标志，但它与未破裂的IAS破裂风险的关系尚未得到很好的描述。
客观化
目的：探讨未破裂型颈内动脉的AWE与常规破裂危险因素的相关性。
方法
对本中心2015年1月至2016年12月收治的未破裂型IAS患者的临床资料和VW-MRI图像进行回顾性分析。110名患者包括140个未破裂的IAS。通过对比增强后和增强前的图像来确定AWE的存在。根据分期评分计算每个病例的破裂风险。采用单因素和多因素分析研究AWE与破裂风险和其他常规危险因素之间的关系。
结果
82个病灶(58.6%)存在AWE。有AWE的未破裂IAS与无AWE的IAS相比，体积明显增大(P<0.01)，形状更不规则(P=0.003)，位置分布不同(P=10.023)。AWE组的破裂风险评分显著高于非AWE组(P<0.01)。多因素分析显示，动脉瘤大小(优势比=1.312~1.798；95%可信区间1.312~1.798；P<0.01)和部位(优势比=1.592；95%可信区间1.237~2.049；P<0.01)与AWE独立相关。
结论
在VW-MRI上AWE的出现与传统的破裂相关特征(包括动脉瘤的大小和位置)高度相关，根据分期评分，AWE在未破裂且破裂风险较高的IAS中更常见。
BACKGROUND
The rupture risk assessment of unruptured intracranial aneurysms (IAs) is still challenging. Aneurysm wall enhancement (AWE) on vessel wall magnetic resonance imaging (VW-MRI) is suggested as a potential marker for wall inflammation, but its relationship with rupture risk of unruptured IAs has not been well described.
OBJECTIVE
To investigate the correlation between AWE and conventional rupture risk factor of unruptured IAs.
METHODS
Clinical data and VW-MRI images were retrospectively reviewed in patients with unruptured IAs from January 2015 to December 2016 in our center. One hundred ten patients harboring 140 unruptured IAs were included. The presence of AWE was determined by comparing the postcontrast VW-MRI images with the precontrast ones. The rupture risk based on the PHASES score was calculated for each case. Univariate and multivariate analysis were performed to investigate the association of AWE with rupture risk and other conventional risk factors.
RESULTS
AWE was present in 82 (58.6%) lesions. Unruptured IAs with AWE had significantly larger size (P < .001), more irregular shape (P = .003), and different distribution of locations (P = .023) comparing with aneurysms without AWE. The rupture risk score of AWE group was significantly higher than non-AWE group (P < .001). Aneurysm size (odds ratio = 1.536; 95% confidential interval 1.312-1.798; P < .001) and location (odds ratio = 1.592; 95% confidential interval 1.237-2.049; P < .001) were independently related with AWE in multivariate analysis.
CONCLUSION
The presence of AWE on VW-MRI was highly associated with conventional rupture-related characteristics, including aneurysmal size and location, and was detected more frequently in unruptured IAs with high rupture risk based on the PHASES score.