摘要
目的探讨高分辨率磁共振成像(high-resolution magnetic resonance imaging,HR-MRI)显示的动脉瘤壁增强(aneurysm wall enhancement,AWE)与颅内动脉瘤破裂风险的相关性。方法回顾性纳入2014年10月至2019年10月期间郑州大学第一附属医院收治的未破裂颅内动脉瘤患者。应用三维数字减影血管造影测量动脉瘤形态学参数,应用HR-MRI评估强化模式。采用单变量分析和多变量logistic回归分析确定AWE的独立影响因素。基于PHASES评分评估颅内动脉瘤的5年破裂风险。采用Spearman秩相关分析确定强化模式与动脉瘤破裂风险的相关性。结果共纳入261例患者和333个未破裂颅内囊状动脉瘤。强化组与非强化组之间多发性动脉瘤的比例以及动脉瘤大小和部位存在显著性差异(P均<0.05)。多变量logistic回归分析显示,校正年龄、性别等混杂因素后,多发性动脉瘤[优势比(odds ratio,OR)0.446,95%可信区间(confidence interval,CI)0.251~0.791;P=0.006]、动脉瘤大小(OR 1.327,95%CI 1.218~1.445;P<0.001)和部位(大脑前动脉/后交通动脉/后循环:OR 2.058,95%CI 1.217~3.482;P=0.007)与AWE存在显著独立相关性。基于PHASES评分,强化组5年预测破裂风险显著高于未强化组(5.2%±6.2%对1.5%±2.0%;P<0.001)。Spearman秩相关分析显示,动脉瘤强化范围与动脉瘤破裂风险呈显著正相关(r=0.435,P<0.001)。结论HR-MRI显示的AWE与多发性动脉瘤、动脉瘤大小和部位相关。应用AWE可预测颅内动脉瘤破裂风险。
Objective To investigate the correlation between aneurysm wall enhancement(AWE)shown on high-resolution magnetic resonance imaging(HR-MRI)and the risk of intracranial aneurysm rupture risk.Methods Patients with unruptured intracranial aneurysm admitted to the First Affiliated Hospital of Zhengzhou University from October 2014 to October 2019 were enrolled retrospectively.Three-dimensional digital subtraction angiography was used to measure the morphological parameters of aneurysms.HR-MRI was used to evaluate the enhancement mode.Univariate analysis and multivariate logistic regression analysis were used to determine the independent influencing factors of AWE.The 5-year rupture risk of intracranial aneurysms was assessed based on the PHASES score.Spearman rank correlation analysis was used to determine the correlation between the enhancement mode and the risk of aneurysm rupture.Results A total of 261 patients and 333 unruptured intracranial saccular aneurysms were included.There were significant differences in the proportion of multiple aneurysms,the size and location of aneurysms between the enhanced group and the non-enhanced group(all P<0.05).Multivariate logistic regression analysis showed that after adjusting for confounding factors such as age and gender,multiple aneurysms(odds ratio[OR]0.446,95%confidence interval[CI]0.251-0.791;P=0.006),aneurysm size(OR 1.327,95%CI 1.218-1.445;P<0.001)and location(anterior cerebral artery/posterior communication artery/posterior circulation:OR 2.058,95%CI 1.217-3.482;P=0.007)were significantly independently related to AWE.Based on the PHASES score,the 5-year predicted rupture risk of the enhanced group was significantly higher than that of the non-enhanced group(5.2%±6.2%vs.1.5%±2.0%;P<0.001).Spearman rank correlation analysis showed that there was a significant positive correlation between the extent of aneurysm enhancement and the risk of aneurysm rupture(r=0.435,P<0.001).Conclusions AWE shown on HR-MRI is associated with multiple aneurysms,aneurysm size,and location.Application of AWE might predict the risk of rupture of intracranial aneurysms.
作者
张伊
付其昌
任翠萍
程敬亮
Zhang Yi;Fu Qichang;Ren Cuiping;Cheng Jingliang(Department of Magnetic Resonance Imaging,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450000,China)
出处
《国际脑血管病杂志》
2020年第4期271-276,共6页
International Journal of Cerebrovascular Diseases
关键词
颅内动脉瘤
动脉瘤
破裂
磁共振成像
钆DTPA
图像增强
危险性评估
Intracranial aneurysm
Aneurysm,ruptured
Magnetic resonance imaging
Gadolinium DTPA
Image enhancement
Risk assessment
