College of Medicine, University of Cincinnati, Cincinnati, Ohio, USA; Department of Neurosurgery, University of Cincinnati, Cincinnati, Ohio, USA.
College of Medicine, University of Cincinnati, Cincinnati, Ohio, USA; Department of Neurosurgery, University of Cincinnati, Cincinnati, Ohio, USA.
World Neurosurg. 2024 Mar;183:214-226.e5. doi: 10.1016/j.wneu.2023.12.131. Epub 2023 Dec 30.
Imaging modalities with increased spatial resolution have allowed for more precise quantification of cerebral aneurysm shape in 3-dimensional (3D) space. We conducted a systematic review and meta-analysis to assess the correlation of individual 3D morphometric measures with cerebral aneurysm rupture status.
Two independent reviewers performed a PRISMA (preferred reporting items of systematic reviews and meta-analysis)-guided literature search to identify articles reporting the association between 3D morphometric measures of intracranial aneurysms and rupture status.
A total of 15,122 articles were identified. After screening, 39 studies were included. We identified 17 3D morphometric measures, with 11 eligible for the meta-analysis. The meta-analysis showed a significant association with rupture status for the following measures: nonsphericity index (standardized mean difference [SMD], 0.66; 95% confidence interval [CI], 0.53-0.79; P < 0.0001; I = 55.2%), undulation index (SMD, 0.55; 95% CI, 0.26-0.85; P = 0.0017; I = 68.1%), ellipticity index (SMD, 0.53; 95% CI, 0.29-0.77; P = 0.0005; I = 70.8%), volume (SMD, 0.18; 95% CI, 0.02-0.35; P = 0.0320; I = 82.3%), volume/ostium ratio (SMD, 0.43; 95% CI, 0.16-0.71; P = 0.0075; I = 90.4%), elongation (SMD, -0.94; 95% CI, -1.12 to -0.76; P = 0.0005; I = 0%), flatness (SMD, -0.87; 95% CI, -1.04 to -0.71; P = 0.0005; I = 0%), and sphericity (SMD, -0.62; 95% CI, -1.06 to -0.17; P = 0.0215; I = 67.9%). A significant risk of publication bias was estimated for the ellipticity index (P = 0.0360) and volume (P = 0.0030).
Based on the results of a meta-analysis containing 39 studies, the nonsphericity index, undulation index, elongation, flatness, and sphericity demonstrated the most consistent correlation with rupture status.
具有更高空间分辨率的成像方式使我们能够更精确地量化三维（3D）空间中脑动脉瘤的形状。我们进行了一项系统评价和荟萃分析，以评估颅内动脉瘤的各个 3D 形态测量指标与破裂状态之间的相关性。
两名独立的审查员进行了 PRISMA（系统评价和荟萃分析的首选报告项目）指导的文献检索，以确定报告颅内动脉瘤的 3D 形态测量指标与破裂状态之间关联的文章。
共确定了 15122 篇文章，经过筛选，共有 39 项研究被纳入。我们确定了 17 个 3D 形态测量指标，其中 11 个指标适合进行荟萃分析。荟萃分析显示，以下指标与破裂状态存在显著关联：非球形指数（标准化均数差 [SMD]，0.66；95%置信区间 [CI]，0.53-0.79；P<0.0001；I=55.2%）、波动指数（SMD，0.55；95%CI，0.26-0.85；P=0.0017；I=68.1%）、椭圆率指数（SMD，0.53；95%CI，0.29-0.77；P=0.0005；I=70.8%）、体积（SMD，0.18；95%CI，0.02-0.35；P=0.0320；I=82.3%）、体积/瘤口比（SMD，0.43；95%CI，0.16-0.71；P=0.0075；I=90.4%）、伸长率（SMD，-0.94；95%CI，-1.12 至-0.76；P=0.0005；I=0%）、扁平度（SMD，-0.87；95%CI，-1.04 至-0.71；P=0.0005；I=0%）和球形度（SMD，-0.62；95%CI，-1.06 至-0.17；P=0.0215；I=67.9%）。椭圆率指数（P=0.0360）和体积（P=0.0030）的发表偏倚风险估计显著。
基于包含 39 项研究的荟萃分析结果，非球形指数、波动指数、伸长率、扁平度和球形度与破裂状态的相关性最为一致。
