Institute of Diagnostic and Interventional Radiology, The Sixth Affiliated People's Hospital, Shanghai Jiao Tong University, No. 600, Yi Shan Road, Shanghai, China.
Neurol India. 2012 Jan-Feb;60(1):45-9. doi: 10.4103/0028-3886.93588.
The aim of this study was to evaluate the anatomical changes and investigate the prevalence in intracranial aneurysm with fenestrations using magnetic resonance angiography (MRA).
Between June 2008 and October 2010, 4652 patients (aged 23-73 years) with suspected intracranial aneurysm or other cerebrovascular diseases underwent MRA examination. MRA was performed using a three-dimensional time-of-flight technique (3D-TOF) with volume rendering (VR) and maximum intensity projection reconstruction methods. The presence and location of fenestrations and aneurysms was reviewed. When fenestrations were present in combination with aneurysms, we noted the relationship of the locations. The classification of fenestration accompanied by intracranial aneurysm was divided into three types according to the anatomical relationship as follows: Type I, aneurysm adjacent to but not on a fenestration; Type II, aneurysm located on the fenestration; type III, aneurysm located at a position remote from a fenestration.
Among the 4652 patients examined, 409 patients were defined with 412 intracranial aneurysms, and the prevalence of aneurysms was 8.8%. One hundred and forty-one patients were identified with fenestrations; 24 of these patients were confirmed with intracranial aneurysms. Seven cases were classified as type I, three as type II and 14 as type III. The prevalence of intracranial aneurysm with fenestrations was 17.0%, with significant statistical difference compared with aneurysms unaccompanied with fenestrations (P=0.0064).
The anatomical relationship between fenestrations and intracranial aneurysms was visualized by MRA with VR, which displayed pathologies with sufficient clarity to enable diagnosis. Furthermore, the results of this study suggest that physicians should be alerted to the occurrence of intracranial aneurysm following the detection of fenestrations by MRA.
本研究旨在通过磁共振血管造影（MRA）评估颅内动脉瘤伴孔的解剖学变化及其发生率。
2008 年 6 月至 2010 年 10 月期间，4652 例疑似颅内动脉瘤或其他脑血管疾病患者接受 MRA 检查。采用三维时间飞跃（3D-TOF）技术，结合容积再现（VR）和最大密度投影重建方法进行 MRA 检查。分析孔和动脉瘤的存在和位置。当孔与动脉瘤并存时，我们记录了其位置关系。根据解剖学关系，将孔伴发颅内动脉瘤的分类分为以下三型：Ⅰ型，动脉瘤毗邻但不在孔上；Ⅱ型，动脉瘤位于孔上；Ⅲ型，动脉瘤位于远离孔的位置。
在 4652 例患者中，409 例患者发现 412 个颅内动脉瘤，动脉瘤发生率为 8.8%。141 例患者存在孔，其中 24 例患者被证实存在颅内动脉瘤。7 例为Ⅰ型，3 例为Ⅱ型，14 例为Ⅲ型。孔伴发颅内动脉瘤的发生率为 17.0%，与无孔伴发的动脉瘤相比差异有统计学意义（P=0.0064）。
MRA 结合 VR 可清晰显示孔与颅内动脉瘤的解剖关系，有助于明确诊断。此外，本研究结果提示，MRA 发现孔后，临床医生应警惕颅内动脉瘤的发生。
