Ahn S J, Kim B M, Jung W S, Suh S H
From the Department of Radiology (S.J.A., W.S.J., S.H.S.), Gangnam Severance Hospital.
Department of Radiology (B.M.K.).
AJNR Am J Neuroradiol. 2015 Feb;36(2):337-41. doi: 10.3174/ajnr.A4121. Epub 2014 Oct 16.
Skull plain films of coiled aneurysms have been used in a limited role, including morphologic comparison of the coil mass. We aimed to evaluate the efficacy of skull plain films in patients treated with detachable coils by using quantitative assessment.
In this retrospective study, 78 pairs of the initial and follow-up skull anteroposterior and lateral images were reviewed independently by 2 neuroradiologists. The largest diameter, the perpendicular diameter, and area of the coil mass were measured separately on plain film, and quantitative changes of parameters were compared between subgroups, which were determined by consensus, depending on the need for retreatment. Subgroup analysis was also performed according to aneurysm size, packing attenuation, and ruptured status.
On skull lateral images, mean quantitative changes of the largest diameter (0.53 ± 0.43 mm versus 1.17 ± 0.91 mm, P < .01), the perpendicular diameter (0.56 ± 0.48 mm versus 1.20 ± 1.05 mm, P < .01), and the area of the coil mass (5.21 ± 7.51 mm(2) versus 10.55 ± 10.93 mm(2), P < .02) differed significantly between subgroups. Receiver operating characteristic analysis showed quantitative change of the largest diameter (>1.1 mm; sensitivity, 50.0%; specificity, 90.3%), the perpendicular diameter (>.9 mm; sensitivity, 62.5%; specificity, 85.5%), and the area (>8.5 mm(2); sensitivity, 50.0%; specificity, 83.9%) on skull lateral films to be indicative of aneurysm recurrence, and the diagnostic accuracy of these parameters increased significantly in the high-packing-attenuation group.
Quantitative measurement of the coil mass by using skull plain lateral images has the potential to predict aneurysm recurrence in follow-up evaluations of intracranial aneurysms with coiling.
颅内动脉瘤弹簧圈栓塞术后颅骨平片的应用有限，包括对弹簧圈团块进行形态学比较。我们旨在通过定量评估来评价颅骨平片在接受可脱性弹簧圈治疗患者中的有效性。
在这项回顾性研究中，2名神经放射科医生独立回顾了78对初次及随访时的颅骨前后位和侧位影像。在平片上分别测量弹簧圈团块的最大直径、垂直直径和面积，并比较亚组间参数的定量变化，亚组根据是否需要再次治疗经共识确定。还根据动脉瘤大小、栓塞致密程度和破裂状态进行了亚组分析。
在颅骨侧位影像上，亚组间弹簧圈团块的最大直径（0.53±0.43mm对1.17±0.91mm，P<.01）、垂直直径（0.56±0.48mm对1.20±1.05mm，P<.01）和面积（5.21±7.51mm²对10.55±10.93mm²，P<.02）的平均定量变化有显著差异。受试者操作特征分析显示，颅骨侧位片上最大直径（>1.1mm；敏感性50.0%；特异性90.3%）、垂直直径（>.9mm；敏感性62.5%；特异性85.5%）和面积（>8.5mm²；敏感性50.0%；特异性83.9%）的定量变化提示动脉瘤复发，且这些参数在高栓塞致密程度组的诊断准确性显著提高。
利用颅骨侧位平片对弹簧圈团块进行定量测量，在颅内动脉瘤弹簧圈栓塞术后的随访评估中有可能预测动脉瘤复发。
