Li Jing, Shen Bixia, Ma Chao, Liu Li, Ren Li, Fang Yibin, Dai Dongwei, Chen Shiyue, Lu Jianping
Department of Radiology, Changhai Hospital of Shanghai, the Second Military Medical University, Shanghai, 200433, China.
Department of neurosurgery, Changhai Hospital of Shanghai, the Second Military Medical University, Shanghai, 200433, China.
PLoS One. 2014 Dec 2;9(12):e114157. doi: 10.1371/journal.pone.0114157. eCollection 2014.
Contrast enhanced MRA (CE-MRA) can help to overcome the limitations of other techniques to clearly display the details of cerebral aneurysms at 1.5-T MR system. We investigated the prevalence of unruptured cerebral aneurysms (UCAs) using three dimensional (3D) CE-MRA in a tertiary comprehensive hospital in China.
The cases were prospectively recorded at our hospital between February 2009 and October 2010. 3D CE-MRA, interpreted by 2 observers blinded to the participants' information, was used to identify the location and size of UCAs and to estimate the overall, age-specific, and sex-specific prevalence.
Of the 3993 patients (men: women = 2159:1834), 408 UCAs were found in 350 patients (men: women = 151:199). The prevalence was 8.8% overall (95% CI, 8.0-10.0%), with 7.0% for men (CI, 6.0-8.0%) and 10.9% for women (CI, 9.0-12.0%). The overall prevalence of UCAs was higher in women than in men (P<0.001) and increased with age both in men and women. Prevalence peaked at age group 75-80 years. Forty-two patients (11.7%) had multiple aneurysms, including 10 (2.9%) male patients and 32 (9.1%) female patients. The most common site of aneurysm was the carotid siphon, and most lesions (71.3%) had a maximum diameter of 3-5 mm.
This hospital-based prevalence study suggested a high prevalence (8.8%) of UCAs and most lesions (71.3%) had a maximum diameter of 3-5 mm observed by 3D CE-MRA. Because the rupture of small cerebral aneurysms was not uncommon, an appropriate follow-up care strategy must be formulated.
对比增强磁共振血管造影（CE-MRA）有助于克服其他技术的局限性，从而在1.5-T磁共振系统中清晰显示脑动脉瘤的细节。我们在中国一家三级综合医院采用三维（3D）CE-MRA对未破裂脑动脉瘤（UCA）的患病率进行了调查。
2009年2月至2010年10月期间，我院对病例进行了前瞻性记录。由两名对参与者信息不知情的观察者解读3D CE-MRA，以确定UCA的位置和大小，并估计总体、年龄特异性和性别特异性患病率。
在3993例患者中（男性：女性=2159:1834），350例患者（男性：女性=151:199）发现了408个UCA。总体患病率为8.8%（95%CI，8.0-10.0%），男性为7.0%（CI，6.0-8.0%），女性为10.9%（CI，9.0-12.0%）。UCA的总体患病率女性高于男性（P<0.001），且男性和女性的患病率均随年龄增长而增加。患病率在75-80岁年龄组达到峰值。42例患者（11.7%）有多个动脉瘤，其中男性患者10例（2.9%），女性患者32例（9.1%）。动脉瘤最常见的部位是颈动脉虹吸部，大多数病变（71.3%）的最大直径为3-5mm。
这项基于医院的患病率研究表明，3D CE-MRA观察到UCA的患病率较高（8.8%），且大多数病变（71.3%）的最大直径为3-5mm。由于小型脑动脉瘤破裂并不罕见，必须制定适当的随访护理策略。
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