高分辨率血管壁 MRI 联合 TOF-MRA 在颅内外椎动脉夹层动脉瘤重建血管内治疗后随访中的诊断性能。
Diagnostic Performance of High-Resolution Vessel Wall MR Imaging Combined with TOF-MRA in the Follow-up of Intracranial Vertebrobasilar Dissecting Aneurysms after Reconstructive Endovascular Treatment.
机构信息
From the Departments of Neurosurgery (S.T., Y.L., X. Zhou, Y.W.).
Department of Neurosurgery (X.X.), The First People's Hospital of Zhaoqing City, Zhaoqing, Guangdong Province, China.
出版信息
AJNR Am J Neuroradiol. 2023 Apr;44(4):453-459. doi: 10.3174/ajnr.A7838. Epub 2023 Mar 23.
BACKGROUND AND PURPOSE
Few studies have reported the utility of high-resolution vessel wall MR imaging in the follow-up of endovascularly treated vertebrobasilar dissecting aneurysms. This study aimed to evaluate the diagnostic performance of high-resolution vessel wall MR imaging combined with TOF-MRA in the follow-up of intracranial vertebrobasilar dissecting aneurysms after reconstructive endovascular treatment.
MATERIALS AND METHODS
Patients with intracranial vertebrobasilar dissecting aneurysms with reconstructive endovascular treatment and followed up with TOF-MRA, high-resolution vessel wall MR imaging, and DSA were included. With DSA as the criterion standard, the diagnostic performance of TOF-MRA, high-resolution vessel wall MR imaging, and high-resolution vessel wall MR imaging combined with TOF-MRA in the evaluation of aneurysm occlusion status and parent artery patency was assessed. Visualization of the stented artery on TOF-MRA and high-resolution vessel wall MR imaging was rated on a 5-point scale.
RESULTS
Twenty-seven patients with 29 aneurysms were included. The sensitivity, specificity, positive predictive value, and negative predictive value of TOF-MRA, high-resolution vessel wall MR imaging, and high-resolution vessel wall MR imaging combined with TOF-MRA for diagnosing aneurysm remnants were 80.0%, 100.0%, 100.0%, and 82.4%; 53.3%, 100.0%, 100.0%, and 66.7%; and 93.3%, 100.0%, 100.0%, and 93.3%, respectively. For the visualization of the stented artery, the mean score of high-resolution vessel wall MR imaging was significantly higher than that of TOF-MRA (4.88 [SD, 0.32] versus 2.53 [SD, 1.25], < .001). In the evaluation of parent artery patency (normal or pathologic), whereas TOF-MRA had a sensitivity, specificity, positive predictive value, and negative predictive value of 100.0%, 8.0%, 14.8%, and 100.0%, respectively, high-resolution vessel wall MR imaging was completely consistent with the DSA.
CONCLUSIONS
High-resolution vessel wall MR imaging combined with TOF-MRA at 3T showed good diagnostic performance in the follow-up of intracranial vertebrobasilar dissecting aneurysms after reconstructive endovascular treatment.
背景与目的
很少有研究报道高分辨率血管壁 MRI 在血管内治疗的椎基底动脉夹层动脉瘤随访中的应用价值。本研究旨在评估高分辨率血管壁 MRI 联合时间飞跃磁共振血管成像（TOF-MRA）在血管内重建治疗后颅内椎基底动脉夹层动脉瘤随访中的诊断性能。
材料与方法
纳入颅内椎基底动脉夹层动脉瘤患者，接受血管内重建治疗，并接受 TOF-MRA、高分辨率血管壁 MRI 和 DSA 随访。以 DSA 为标准，评估 TOF-MRA、高分辨率血管壁 MRI 和高分辨率血管壁 MRI 联合 TOF-MRA 对动脉瘤闭塞状态和载瘤动脉通畅性的评估诊断性能。TOF-MRA 和高分辨率血管壁 MRI 上支架动脉的可视化评分采用 5 分制。
结果
共纳入 27 例患者，29 个动脉瘤。TOF-MRA、高分辨率血管壁 MRI 和高分辨率血管壁 MRI 联合 TOF-MRA 诊断动脉瘤残腔的敏感度、特异度、阳性预测值和阴性预测值分别为 80.0%、100.0%、100.0%和 82.4%、53.3%、100.0%、100.0%和 66.7%、93.3%、100.0%、100.0%和 93.3%。支架动脉的可视化方面，高分辨率血管壁 MRI 的平均评分明显高于 TOF-MRA（4.88[标准差，0.32]比 2.53[标准差，1.25]，<0.001）。在载瘤动脉通畅性（正常或病理性）评估中，TOF-MRA 的敏感度、特异度、阳性预测值和阴性预测值分别为 100.0%、8.0%、14.8%和 100.0%，而高分辨率血管壁 MRI 与 DSA 完全一致。
结论
3T 高分辨率血管壁 MRI 联合 TOF-MRA 对血管内重建治疗后颅内椎基底动脉夹层动脉瘤的随访具有良好的诊断性能。
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