Lamparski Krzysztof Jacek, Procyk Grzegorz, Sajdek Michał, Gąsecka Aleksandra, Dryjańska-Lamparska Alicja, Maj Edyta, Januszewicz Magdalena, Wojtaszek Mikolaj
2 Department of Clinical Radiology, Medical University of Warsaw, Poland.
1 Chair and Department of Cardiology, Medical University of Warsaw, Poland.
Pol J Radiol. 2025 May 13;90:e224-e233. doi: 10.5114/pjr/203730. eCollection 2025.
Endovascular procedures have become the method of choice for treating splenic artery aneurysms (SSAs). However, there is no consensus regarding the intervals and imaging methods for follow-up examinations in patients with true SAAs treated with coil embolisation. We aimed to evaluate the utility of digital subtraction angiography (DSA), computed tomography angiography (CTA), magnetic resonance angiography (MRA), contrast-enhanced ultrasound, and duplex ultrasound (DUS) for follow-up screening of patients with SAAs treated with coil embolisation.
We conducted a systematic review according to the PRISMA 2020 Statement. We searched 5 databases: Embase, Medline Ultimate, PubMed, Scopus, and Web of Science, each up to 10 April 2024. Eventually, 20 relevant original studies were included.
DSA is an invasive procedure that requires ionising radiation and should not be performed as a routine check-up. CTA is an appropriate examination method in patients immediately after coil embolisation in whom severe complications, primarily bleeding, are suspected. Still, it is unsuitable for assessing persistent aneurysmal sac perfusion. MRA is a promising noninvasive technique that does not require ionising radiation. Several studies have demonstrated the superiority of MRA over DSA in detecting small aneurysmal sac reperfusion. DUS, while not a standalone method, may supplement MRA in patients at low risk of reintervention.
The evidence regarding follow-up imaging methods after SAAs coil embolisation is limited and of low quality. MRA should be preferred over DSA for detecting aneurysmal sac reperfusion. Due to artifacts, CTA is suitable for emergency cases but not for routine follow-up.
血管内介入手术已成为治疗脾动脉瘤（SAA）的首选方法。然而，对于接受弹簧圈栓塞治疗的真性SAA患者的随访检查间隔和成像方法尚无共识。我们旨在评估数字减影血管造影（DSA）、计算机断层血管造影（CTA）、磁共振血管造影（MRA）、超声造影和双功超声（DUS）在接受弹簧圈栓塞治疗的SAA患者随访筛查中的应用价值。
我们根据PRISMA 2020声明进行了系统评价。我们检索了5个数据库：Embase、Medline Ultimate、PubMed、Scopus和Web of Science，检索截至2024年4月10日。最终纳入了20项相关的原始研究。
DSA是一种侵入性检查，需要电离辐射，不应作为常规检查进行。CTA是弹簧圈栓塞后立即怀疑有严重并发症（主要是出血）的患者的合适检查方法。然而，它不适用于评估持续性动脉瘤囊灌注。MRA是一种有前景的非侵入性技术，不需要电离辐射。多项研究已证明MRA在检测小动脉瘤囊再灌注方面优于DSA。DUS虽然不是独立的方法，但在再干预风险低的患者中可补充MRA。
关于SAA弹簧圈栓塞后随访成像方法的证据有限且质量较低。在检测动脉瘤囊再灌注方面，MRA应优于DSA。由于伪影，CTA适用于紧急情况，但不适用于常规随访。
