Yu Zhen, Geng Jiewen, Zhao Zhi, Wang Simin, Hu Peng, He Chuan, Zhang Hongqi
Department of Neurosurgery, Beijing Xuanwu Hospital, Capital Medical University, Beijing, China.
Interv Neuroradiol. 2025 Aug 28:15910199251345641. doi: 10.1177/15910199251345641.
PurposeTo assess the diagnostic value of silent MRA in the follow-up of intracranial aneurysms (IA) post-endovascular treatment.MethodsFrom March 2023 to March 2024, we retrospectively collected data on patients with IA who underwent endovascular intervention and received silent MRA follow-up. All images were anonymized and evaluated on a 5-point scale: 1 (not visible, strong artifacts); 2 (poor quality, numerous artifacts/blurring); 3 (acceptable quality, moderate artifacts/blurring); 4 (good quality, minor blur artifacts); 5 (very good quality, nearly equal to DSA). The quality and occlusion status of aneurysms were descriptively analyzed.ResultsA total of 451 patients with 475 IA treated at our hospital received silent MRA follow-up. The silent MRA showed 100% 5-point scores in the coil embolization group. In the stent-assisted group, 65.7% achieved a 5-point score, and in the flow-diverter (FD) group, 42.6%. The multiple telescopic stents group had only 7.1% with a 5-point score, while the intrasaccular flow disruption group had 55.6%, and the FD+ coil group had 40.7%. There were two cases of distal aneurysms: one A3 segment aneurysm scored 5 points on silent MRA while the other M3 segment aneurysm did not visualize the aneurysm artery. A ≥3 score was helpful for diagnosing postoperative recurrence, with rates of 100%, 97.8%, 87.9%, 57.1%, 88.9%, 85.2%, and 50% across the groups.ConclusionsSilent MRA shows significant potential for postoperative follow-up in endovascular therapy of aneurysms, particularly in interventions of coiling embolization, stent-assisted coiling, and FD.
目的
评估无声磁共振血管造影（MRA）在颅内动脉瘤（IA）血管内治疗后随访中的诊断价值。
方法
回顾性收集2023年3月至2024年3月期间接受血管内介入治疗并进行无声MRA随访的IA患者的数据。所有图像均进行匿名处理，并采用5分制进行评估：1分（不可见，严重伪影）；2分（质量差，大量伪影/模糊）；3分（质量可接受，中度伪影/模糊）；4分（质量好，轻微模糊伪影）；5分（质量非常好，几乎等同于数字减影血管造影（DSA））。对动脉瘤的质量和闭塞状态进行描述性分析。
结果
我院共451例患有475个IA的患者接受了无声MRA随访。在弹簧圈栓塞组中，无声MRA的5分评分率为100%。在支架辅助组中，65.7%达到5分评分，在血流导向装置（FD）组中为42.6%。多节段支架组只有7.1%达到5分评分，而瘤内血流阻断组为55.6%，FD+弹簧圈组为40.7%。有2例远端动脉瘤：1例A3段动脉瘤在无声MRA上评分为5分，而另1例M3段动脉瘤未显示动脉瘤血管。≥3分有助于诊断术后复发，各治疗组的复发率分别为100%、97.8%、87.9%、57.1%、88.9%、85.2%和50%。
结论
无声MRA在动脉瘤血管内治疗术后随访中显示出巨大潜力，尤其在弹簧圈栓塞、支架辅助弹簧圈栓塞和FD介入治疗中。
