Lee Man Cho, Fung King Him, Liu Shing Him, Ko Koel Wei Sum, Chan Nok Lun, Mahboobani Neeraj Ramesh, Shek Ka Wai, Poon Tak Lap, Poon Wai Lun
Queen Elizabeth Hospital, Hong Kong.
Prince of Wales Hospital, Hong Kong.
Diagnostics (Basel). 2025 Jul 14;15(14):1774. doi: 10.3390/diagnostics15141774.
MRA is used in our center for monitoring post-treatment residual aneurysmal neck and stent patency. IV CBCT offers better spatial resolution and may provide significant advantages. This study investigates the image quality of IV CBCT compared to that of MRA for the follow-up of intracranial aneurysms. In this prospective cohort study, 97 patients (mean age: 63.1 ± 11.7; 75 women and 22 men) with 114 treated cerebral aneurysms were included from July 2023 to April 2024. All patients underwent IV CBCT and MRA on the same day. Two neurointerventional radiologists assessed image quality using a five-point Likert scale on two separate occasions six weeks apart. Diagnostic values were evaluated across six parameters. Intra-observer and inter-observer agreements were calculated. Subgroup analyses were performed. Overall, IV CBCT and MRA are comparable in terms of their ability to assess parent vessel status and the degree of artifacts ( > 0.05) though MRA shows a slight advantage in evaluating residual aneurysmal neck ( = 0.05). For clipped aneurysms, IV CBCT is superior in assessing residual aneurysmal neck (OR = 16.0, < 0.001) and parent vessel status (OR = 15.1, < 0.001) with significantly fewer artifacts (OR > 100, < 0.001). For aneurysms solely treated with stents, IV CBCT is superior in assessing residual aneurysmal neck (OR > 20, = 0.002) and parent vessel status (OR > 20, = 0.002) with significantly fewer artifacts (OR > 20, = 0.002). IV CBCT outperforms MRA in evaluating stent struts and the vessel wall status of a stented segment when MRA is non-diagnostic. IV CBCT and MRA have their own strengths and roles in the follow-up of post-treatment intracranial aneurysms. Overall, IV CBCT is superior in terms of its assessment of intracranial aneurysms treated solely with stents or surgical clips.
在我们中心，磁共振血管造影（MRA）用于监测治疗后残留的动脉瘤颈部和支架通畅情况。静脉注射计算机断层血管造影（IV CBCT）具有更好的空间分辨率，可能具有显著优势。本研究调查了与MRA相比，IV CBCT在颅内动脉瘤随访中的图像质量。在这项前瞻性队列研究中，纳入了2023年7月至2024年4月期间97例（平均年龄：63.1±11.7岁；75名女性和22名男性）患有114个已治疗脑动脉瘤的患者。所有患者在同一天接受了IV CBCT和MRA检查。两名神经介入放射科医生在相隔六周的两个不同时间，使用五点李克特量表评估图像质量。对六个参数的诊断价值进行了评估。计算了观察者内和观察者间的一致性。进行了亚组分析。总体而言，尽管MRA在评估残留动脉瘤颈部方面显示出轻微优势（P = 0.05），但IV CBCT和MRA在评估供血血管状态和伪影程度方面具有可比性（P>0.05）。对于夹闭的动脉瘤，IV CBCT在评估残留动脉瘤颈部（比值比[OR]=16.0，P<0.001）和供血血管状态（OR = 15.1，P<0.001）方面更具优势，且伪影明显更少（OR>100，P<0.001）。对于仅接受支架治疗的动脉瘤，IV CBCT在评估残留动脉瘤颈部（OR>20，P = 0.002）和供血血管状态（OR>20，P = 0.002）方面更具优势，且伪影明显更少（OR>20，P = 0.002）。当MRA无法诊断时，IV CBCT在评估支架小梁和支架置入段的血管壁状态方面优于MRA。IV CBCT和MRA在治疗后颅内动脉瘤的随访中各有优势和作用。总体而言，IV CBCT在评估仅接受支架或手术夹闭治疗的颅内动脉瘤方面更具优势。
