Department of Interventional Neuroradiology, Pitié-Salpêtrière Hospital, Paris, France.
Department of Neurosurgical Anesthesiology and Intensive Care, Pitié-Salpêtrière Hospital, Paris, France.
J Neurointerv Surg. 2024 Jul 16;16(8):838-845. doi: 10.1136/jnis-2023-020060.
Non-ischemic cerebral enhancing (NICE) lesions following aneurysm endovascular therapy are exceptionally rare, with unknown longitudinal evolution.
To evaluate the radiological behavior of individual NICE lesions over time.
Patients included in a retrospective national multicentric inception cohort were analyzed. NICE lesions were defined, using MRI, as delayed onset punctate, nodular, or annular foci enhancements with peri-lesion edema, distributed in the vascular territory of the aneurysm treatment, with no other confounding disease. Lesion burden and the longitudinal behavior of individual lesions were assessed.
Twenty-two patients were included, with a median initial lesion burden of 36 (IQR 17-54) on the first MRI scan. Of the 22 patients with at least one follow-up MRI scan, 16 (73%) had new lesions occurring mainly within the first 200 weeks after the date of the procedure. The median number of new lesions per MRI was 6 (IQR 2-16). Among the same 22 patients, 7 (32%) had recurrent lesions. The median persistent enhancement of a NICE lesion was 13 weeks (IQR 6-30). No factor was predictive of early regression of enhancement activity with lesion regression kinetics mainly being patient-dependent.
The behavior of individual NICE lesions was found to be highly variable with an overall patient-dependent regression velocity.
动脉瘤血管内治疗后出现非缺血性脑强化（NICE）病变极为罕见，其纵向演变也未知。
评估个体 NICE 病变随时间的放射学行为。
分析纳入回顾性全国多中心发病队列的患者。MRI 定义 NICE 病变为延迟出现的点状、结节状或环形强化灶，伴病变周围水肿，分布于动脉瘤治疗的血管区域，无其他混杂性疾病。评估病变负荷和个体病变的纵向行为。
共纳入 22 例患者，首次 MRI 扫描时中位数初始病变负荷为 36（IQR 17-54）。22 例至少有一次随访 MRI 扫描的患者中，16 例（73%）主要在手术后 200 周内出现新病变。每次 MRI 出现的新病变中位数为 6（IQR 2-16）。在同一 22 例患者中，7 例（32%）出现复发性病变。NICE 病变的中位持续强化时间为 13 周（IQR 6-30）。没有任何因素可预测强化活动的早期消退，病变消退动力学主要取决于患者。
个体 NICE 病变的行为表现高度可变，总体上取决于患者的消退速度。
