Department of Neurology and Neurosurgery, UMC Utrecht Brain Centre, University Medical Centre Utrecht, Utrecht University, Utrecht, the Netherlands.
Department of Neurology and Neurosurgery, UMC Utrecht Brain Centre, University Medical Centre Utrecht, Utrecht University, Utrecht, the Netherlands.
J Neurol Sci. 2024 Sep 15;464:123160. doi: 10.1016/j.jns.2024.123160. Epub 2024 Jul 30.
Radiological screening for intracranial aneurysms (IAs) may identify other relevant intracranial findings. We investigated their prevalence on MR in persons screened for IAs.
We included all persons who were screened for the presence of IAs with brain MRI/MRA between 1996 and 2022 because of a family history of aneurysmal subarachnoid haemorrhage (aSAH) or autosomal dominant polycystic kidney disease (ADPKD). We reviewed radiology reports of initial and repeated brain MR to identify additional intracranial findings that needed follow-up or treatment, or carried a risk of becoming symptomatic.
We included 766 persons (positive family history of aSAH: n = 681; ADPKD: n = 85) who had 1446 MRI/MRAs. At initial screening, 49 additional relevant intracranial findings were reported in 47 persons (6.1%, 95% CI 4.7-8.1%). Of all included persons, 338 (44%) underwent one (n = 154) or more (n = 184) follow-up screenings (total MRI/MRAs at follow-up: n = 680). In 15/338 persons (4.4%, 95% CI 2.7-7.2%), 16 new additional relevant findings were reported at a median follow-up duration of 10 years (IQR 5-12).
Persons who are counselled for screening for IAs should be informed that there is a six percent chance of identifying an additional finding that requires follow-up or treatment, or may become symptomatic. Additionally, after 10-year follow-up screening there is a four percent chance of identifying a new additional relevant finding. The impact of such findings on quality of life needs further study.
颅内动脉瘤（IA）的放射学筛查可能会发现其他相关的颅内发现。我们研究了在因颅内动脉瘤家族史或常染色体显性多囊肾病（ADPKD）而接受脑 MRI/MRA 筛查的人群中这些发现的患病率。
我们纳入了 1996 年至 2022 年间因颅内动脉瘤家族史（蛛网膜下腔出血史 aSAH：n=681；ADPKD：n=85）而接受脑 MRI/MRA 筛查的所有患者。我们回顾了初始和重复脑 MRI 的放射学报告，以确定需要随访或治疗的其他颅内发现，或有出现症状风险的颅内发现。
我们纳入了 766 名患者（aSAH 阳性家族史：n=681；ADPKD：n=85），共进行了 1446 次 MRI/MRA。在初始筛查中，47 名患者报告了 49 项额外的相关颅内发现（6.1%，95%CI 4.7-8.1%）。所有纳入的患者中，338 名（44%）接受了一次（n=154）或多次（n=184）随访筛查（总随访 MRI/MRA：n=680）。在 338 名患者中，有 15 名（4.4%，95%CI 2.7-7.2%）在中位随访 10 年（IQR 5-12）时报告了 16 项新的额外相关发现。
接受颅内动脉瘤筛查咨询的患者应被告知，有 6%的机会发现需要随访或治疗的额外发现，或者可能出现症状。此外，在 10 年的随访筛查后，有 4%的机会发现新的额外相关发现。这些发现对生活质量的影响需要进一步研究。
