From the Department of Biomedical Engineering (H.Q., X.L., H.C.), Tsinghua University, Beijing, China.
Department of Interventional Neuroradiology (P.L., A.L.,Y.J., Y.L.), Beijing Neurosurgical Institute and Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
AJNR Am J Neuroradiol. 2019 Mar;40(3):490-496. doi: 10.3174/ajnr.A5983. Epub 2019 Feb 21.
Individual assessment of the absolute risk of intracranial aneurysm rupture remains challenging. Emerging imaging techniques such as dynamic contrast-enhanced MR imaging and postcontrast vessel wall MR imaging may improve risk estimation by providing new information on aneurysm wall properties. The purpose of this study was to investigate the relationship between aneurysm wall permeability on dynamic contrast-enhanced MR imaging and aneurysm wall enhancement on postcontrast vessel wall MR imaging in unruptured intracranial aneurysms.
Patients with unruptured saccular intracranial aneurysms were imaged with vessel wall MR imaging before and after gadolinium contrast administration. Dynamic contrast-enhanced MR imaging was performed coincident with contrast injection using 3D T1-weighted spoiled gradient-echo imaging. The transfer constant ( ) was measured adjacent to intracranial aneurysm and adjacent to the normal intracranial artery.
Twenty-nine subjects were analyzed (mean age, 53.9 ± 13.5 years; 24% men; PHASES score: median, 8; interquartile range, 4.75-10). was higher in intracranial aneurysms compared with the normal intracranial artery (median, 0.0110; interquartile range, 0.0060-0.0390 versus median, 0.0032; interquartile range, 0.0018-0.0048 min; < .001), which correlated with intracranial aneurysm size (Spearman ρ = 0.54, = .002) and PHASES score (ρ = 0.40, = .30). Aneurysm wall enhancement, detected in 19 (66%) aneurysms, was associated with intracranial aneurysm size and the PHASES score but not significantly with ( = .30). Aneurysms of 2 of the 9 patients undergoing conservative treatment ruptured during 1-year follow-up. Both ruptured aneurysms had increased , whereas only 1 had aneurysm wall enhancement at baseline.
Dynamic contrast-enhanced MR imaging showed increased adjacent to intracranial aneurysms, which was independent of aneurysm wall enhancement on postcontrast vessel wall MR imaging. Increased aneurysm wall permeability on dynamic contrast-enhanced MR imaging provides new information that may be useful in intracranial aneurysm risk assessment.
颅内动脉瘤破裂的个体风险评估仍然具有挑战性。新兴的成像技术，如动态对比增强磁共振成像和对比后血管壁磁共振成像，通过提供关于动脉瘤壁特性的新信息，可能会改善风险评估。本研究的目的是探讨未破裂颅内动脉瘤中，动态对比增强磁共振成像上的动脉瘤壁通透性与对比后血管壁磁共振成像上的动脉瘤壁增强之间的关系。
对 29 例未破裂的囊状颅内动脉瘤患者进行血管壁磁共振成像检查，包括对比前和对比后扫描。使用三维 T1 加权扰相梯度回波成像在对比剂注射的同时进行动态对比增强磁共振成像。在颅内动脉瘤旁和正常颅内动脉旁测量转移常数（）。
29 例患者被纳入分析（平均年龄 53.9±13.5 岁；24%为男性；PHASES 评分中位数为 8，四分位距为 4.75-10）。颅内动脉瘤旁的值高于正常颅内动脉旁（中位数 0.0110，四分位距 0.0060-0.0390 与中位数 0.0032，四分位距 0.0018-0.0048 min；<0.001），且与颅内动脉瘤大小相关（Spearman ρ=0.54，=0.002）和 PHASES 评分相关（ρ=0.40，=0.30）。19 例（66%）动脉瘤中检测到动脉瘤壁增强，与颅内动脉瘤大小和 PHASES 评分相关，但与值无显著相关性（=0.30）。9 例接受保守治疗的患者中有 2 例在 1 年随访期间破裂。这 2 例破裂的动脉瘤均表现出值升高，而仅有 1 例在基线时出现动脉瘤壁增强。
动态对比增强磁共振成像显示颅内动脉瘤旁的值增加，这与对比后血管壁磁共振成像上的动脉瘤壁增强无关。动态对比增强磁共振成像上的动脉瘤壁通透性增加提供了新的信息，可能有助于颅内动脉瘤的风险评估。
