Departments of Neurosurgery, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands.
Departments of Radiology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands.
Eur J Neurol. 2021 Mar;28(3):837-843. doi: 10.1111/ene.14636. Epub 2020 Dec 3.
The Unruptured Intracranial Aneurysm Treatment Score (UIATS) was built to harmonize the treatment decision making on unruptured intracranial aneurysms. Therefore, it may also function as a predictor of aneurysm progression. In this study, we aimed to assess the validity of the UIATS model to identify aneurysms at risk of growth or rupture during follow-up.
We calculated the UIATS for a consecutive series of conservatively treated unruptured intracranial aneurysms, included in our prospectively kept neurovascular database. Computed tomography angiography and/or magnetic resonance angiography imaging at baseline and during follow-up was analyzed to detect aneurysm growth. We defined rupture as a cerebrospinal fluid or computed tomography-proven subarachnoid hemorrhage. We calculated the area under the receiver operator curve, sensitivity, and specificity, to determine the performance of the UIATS model.
We included 214 consecutive patients with 277 unruptured intracranial aneurysms. Aneurysms were followed for a median period of 1.3 years (range 0.3-11.7 years). During follow-up, 17 aneurysms enlarged (6.1%), and two aneurysms ruptured (0.7%). The UIATS model showed a sensitivity of 80% and a specificity of 44%. The area under the receiver operator curve was 0.62 (95% confidence interval 0.46-0.79).
Our observational study involving consecutive patients with an unruptured intracranial aneurysm showed poor performance of the UIATS model to predict aneurysm growth or rupture during follow-up.
未破裂颅内动脉瘤治疗评分（UIATS）旨在协调未破裂颅内动脉瘤的治疗决策，因此，它也可能作为动脉瘤进展的预测因子。本研究旨在评估 UIATS 模型识别在随访期间有生长或破裂风险的动脉瘤的有效性。
我们计算了连续系列保守治疗的未破裂颅内动脉瘤的 UIATS，这些动脉瘤被纳入我们前瞻性保存的神经血管数据库中。对基线和随访期间的计算机断层血管造影和/或磁共振血管造影成像进行分析，以检测动脉瘤生长。我们将破裂定义为蛛网膜下腔出血或计算机断层证实的蛛网膜下腔出血。我们计算了接收者操作特征曲线下的面积、敏感性和特异性，以确定 UIATS 模型的性能。
我们纳入了 214 例连续患者的 277 个未破裂颅内动脉瘤。动脉瘤的随访中位数时间为 1.3 年（范围 0.3-11.7 年）。在随访期间，17 个动脉瘤增大（6.1%），2 个动脉瘤破裂（0.7%）。UIATS 模型的敏感性为 80%，特异性为 44%。接收者操作特征曲线下的面积为 0.62（95%置信区间 0.46-0.79）。
我们的观察性研究涉及连续的未破裂颅内动脉瘤患者，结果表明 UIATS 模型在预测随访期间的动脉瘤生长或破裂方面表现不佳。
