Rennes University Hospital, Department of Neuroradiology, 2, rue Henri-Le-Guilloux, 35033 Rennes, France.
Rennes University Hospital, Department of Neuroradiology, 2, rue Henri-Le-Guilloux, 35033 Rennes, France.
J Neuroradiol. 2018 Oct;45(6):343-348. doi: 10.1016/j.neurad.2018.02.010. Epub 2018 Mar 7.
The WEB is an innovative flow disruption device for cerebral aneurysm embolization with rapidly expanding indications. Our purpose was to evaluate the diagnostic performance of computed tomography angiography (CTA) at 1-year follow-up of aneurysms treated with the WEB.
Between April 2014 and May 2016, the study prospectively included patients treated with the WEB at our institution, and followed up within 24hours by CTA and at 1year by CTA, time-of-flight magnetic resonance angiography (TOF MRA) and digital subtraction angiography (DSA). The diagnostic quality of imaging data was assessed based on the confidence index, artifacts, and WEB shape depiction. The imaging diagnostic performance was assessed using 3 criteria at 1year: aneurysm occlusion status and worsening, and WEB shape compression. Interobserver and intermodality agreement was determined by calculating κ values.
The study ultimately included 16 patients (9 women, mean age 53±7.6years). CTA quality confidence was scored as 2/2, artifacts 0.4/2 and WEB shape depiction 1.9/2, superior to TOF MRA for the latter two criteria. Aneurysm occlusion was adequate in 93.7% of patients, with CTA showing excellent interobserver reproducibility and agreement with DSA on a 4-grade scale (κ=1.00), while TOF MRA yielded good reproducibility (κ=0.76) and agreement with DSA (κ=0.69). CTA also identified aneurysm occlusion worsening (43.7%) and WEB compression (81.2%) in excellent agreement with DSA (κ=0.85 and 1.00).
CTA is a reproducible and reliable technique for the follow-up of aneurysms treated with the WEB device.
WEB 是一种创新性的血流阻断装置，可用于脑动脉瘤栓塞，适应证不断扩大。我们旨在评估使用 WEB 治疗的动脉瘤患者在 1 年随访时 CT 血管造影（CTA）的诊断性能。
2014 年 4 月至 2016 年 5 月，本研究前瞻性纳入在我院接受 WEB 治疗的患者，在 24 小时内行 CTA 检查，并于 1 年时行 CTA、时飞磁共振血管造影（TOF MRA）和数字减影血管造影（DSA）检查。基于置信指数、伪影和 WEB 形态描述来评估成像数据的诊断质量。使用 3 项标准评估 1 年后的成像诊断性能：动脉瘤闭塞状态和恶化情况，以及 WEB 形态压迫。通过计算 κ 值来确定观察者间和模态间的一致性。
最终纳入 16 例患者（9 例女性，平均年龄 53±7.6 岁）。CTA 质量的置信评分均为 2/2，伪影评分为 0.4/2，WEB 形态评分为 1.9/2，后两项评分均优于 TOF MRA。93.7%的患者动脉瘤闭塞充分，CTA 在 4 级评分上具有极好的观察者间可重复性和与 DSA 的一致性（κ=1.00），而 TOF MRA 具有良好的可重复性（κ=0.76）和与 DSA 的一致性（κ=0.69）。CTA 也能极好地识别动脉瘤闭塞恶化（43.7%）和 WEB 压迫（81.2%），与 DSA 具有极好的一致性（κ=0.85 和 1.00）。
CTA 是一种可重复、可靠的技术，可用于 WEB 装置治疗的动脉瘤随访。
