血管壁 MRI 上的动脉瘤壁增强有助于区分稳定型和不稳定型颅内动脉瘤吗？
Does aneurysmal wall enhancement on vessel wall MRI help to distinguish stable from unstable intracranial aneurysms?
机构信息
From the Departments of Radiology (M.E., C.R.-R., D.T., W.B.H., S.L., J.F.M., C.O., O.N.) and Neurosurgery (F.N.), Université Paris Descartes Sorbonne Paris Cité, INSERM S894, Centre Hospitalier Sainte-Anne, Paris, France; Department of Interventional Neuroradiology, University of Montreal, CHUM Notre-Dame Hospital, Montreal, Quebec, Canada (J.-C.G., J.R.); and the Departments of Medical Physics and Radiology (O.W., P.T.), University of Wisconsin, Madison.
出版信息
Stroke. 2014 Dec;45(12):3704-6. doi: 10.1161/STROKEAHA.114.006626. Epub 2014 Oct 16.
BACKGROUND AND PURPOSE
Arterial wall enhancement on vessel wall MRI was described in intracranial inflammatory arterial disease. We hypothesized that circumferential aneurysmal wall enhancement (CAWE) could be an indirect marker of aneurysmal wall inflammation and, therefore, would be more frequent in unstable (ruptured, symptomatic, or undergoing morphological modification) than in stable (incidental and nonevolving) intracranial aneurysms.
METHODS
We prospectively performed vessel wall MRI in patients with stable or unstable intracranial aneurysms. Two readers independently had to determine whether a CAWE was present.
RESULTS
We included 87 patients harboring 108 aneurysms. Interreader and intrareader agreement for CAWE was excellent (κ=0.85; 95% confidence interval, 0.75-0.95 and κ=0.90; 95% confidence interval, 0.83-0.98, respectively). A CAWE was significantly more frequently seen in unstable than in stable aneurysms (27/31, 87% versus 22/77, 28.5%, respectively; P<0.0001). Multivariate logistic regression, including CAWE, size, location, multiplicity of aneurysms, and daily aspirin intake, revealed that CAWE was the only independent factor associated with unstable status (odds ratio, 9.20; 95% confidence interval, 2.92-29.0; P=0.0002).
CONCLUSIONS
CAWE was more frequently observed in unstable intracranial aneurysms and may be used as a surrogate of inflammatory activity in the aneurysmal wall.
背景与目的
血管壁磁共振成像（MRI）上的动脉壁增强在颅内炎症性动脉疾病中已有描述。我们假设环状瘤壁增强（CAWE）可能是瘤壁炎症的间接标志物，因此在不稳定（破裂、有症状或进行形态学改变）颅内动脉瘤中比稳定（偶然发现且无进展）颅内动脉瘤更为常见。
方法
我们前瞻性地对稳定或不稳定颅内动脉瘤患者进行血管壁 MRI 检查。两名读者独立判断是否存在 CAWE。
结果
我们纳入了 87 例患者的 108 个动脉瘤。CAWE 的读者间和读者内一致性非常好（κ=0.85；95%置信区间，0.75-0.95 和 κ=0.90；95%置信区间，0.83-0.98）。不稳定动脉瘤中 CAWE 的发生率明显高于稳定动脉瘤（27/31，87%比 22/77，28.5%；P<0.0001）。包括 CAWE、大小、位置、动脉瘤数量和每日阿司匹林摄入在内的多变量逻辑回归显示，CAWE 是与不稳定状态相关的唯一独立因素（优势比，9.20；95%置信区间，2.92-29.0；P=0.0002）。
结论
不稳定颅内动脉瘤中更常观察到 CAWE，并且可能作为动脉瘤壁炎症活性的替代标志物。
Zotero 插件