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Abstract：
To elucidate the incidence rate of enlargement of vertebral artery dissecting aneurysms (VADAs) during the acute phase and factors associated with enlargement.
Of 115 patients with unilateral intracranial vertebral artery dissection who did not experience subarachnoid hemorrhage, 64 with the pearl sign of vertebral artery dissection (VADA without stenosis) participated in the study. We performed initial magnetic resonance imaging to diagnose VADA and subsequent magnetic resonance imaging to evaluate VADA enlargement. The presence of a hyperintense intramural signal was confirmed using T1-weighted three-dimensional turbo spin-echo imaging. Enlargement of VADAs between the initial and subsequent examinations was evaluated via magnetic resonance angiography and defined as the end point. We studied the rate of VADA enlargement using Kaplan-Meier curve analysis. After independent variables were determined, the Cox proportional hazards model was applied in multivariable analysis to identify the factors significantly associated with VADA enlargement.
Of 64 patients (mean age, 55.7 ± 13.0 years; 44 men and 20 women), 15 exhibited VADA enlargement. Kaplan-Meier curve analysis indicated that 24.8% of VADA enlargements were detected 30 days after initial magnetic resonance imaging. The Cox proportional hazards model revealed that young age (hazard ratio 0.953, P = 0.043) and the presence of hyperintense intramural signal (hazard ratio 2.841, P = 0.033) were significantly associated with VADA enlargement.
VADAs enlarged by approximately 25% until day 30 after the initial examination. Younger age and the presence of hyperintense intramural signal were significantly associated with VADA enlargement.
Of 115 patients with unilateral intracranial vertebral artery dissection who did not experience subarachnoid hemorrhage, 64 with the pearl sign of vertebral artery dissection (VADA without stenosis) participated in the study. We performed initial magnetic resonance imaging to diagnose VADA and subsequent magnetic resonance imaging to evaluate VADA enlargement. The presence of a hyperintense intramural signal was confirmed using T1-weighted three-dimensional turbo spin-echo imaging. Enlargement of VADAs between the initial and subsequent examinations was evaluated via magnetic resonance angiography and defined as the end point. We studied the rate of VADA enlargement using Kaplan-Meier curve analysis. After independent variables were determined, the Cox proportional hazards model was applied in multivariable analysis to identify the factors significantly associated with VADA enlargement.
Of 64 patients (mean age, 55.7 ± 13.0 years; 44 men and 20 women), 15 exhibited VADA enlargement. Kaplan-Meier curve analysis indicated that 24.8% of VADA enlargements were detected 30 days after initial magnetic resonance imaging. The Cox proportional hazards model revealed that young age (hazard ratio 0.953, P = 0.043) and the presence of hyperintense intramural signal (hazard ratio 2.841, P = 0.033) were significantly associated with VADA enlargement.
VADAs enlarged by approximately 25% until day 30 after the initial examination. Younger age and the presence of hyperintense intramural signal were significantly associated with VADA enlargement.
摘要：
目的阐明椎动脉夹层动脉瘤(VADAs)急性期扩大的发生率及扩大的相关因素。
在115例未经历蛛网膜下腔出血的单侧颅内椎动脉夹层患者中，64例椎动脉夹层珍珠征（无狭窄的VADA）参与了研究。我们进行了初始磁共振成像以诊断VADA，随后进行了磁共振成像以评估VADA扩大。使用T1加权三维涡轮自旋回波成像确认了高强度壁内信号的存在。通过磁共振血管造影术评估初始和后续检查之间的VADA扩大情况，并将其定义为终点。我们使用Kaplan-Meier曲线分析研究了VADA的扩大率。自变量确定后，Cox比例风险模型应用于多变量分析,以确定与VADA扩大显著相关的因素.
64名患者(平均年龄，55.7±13.0岁；44名男性和20名女性），15展示了VADA扩大。Kaplan-Meier曲线分析表明，在初始磁共振成像后30天检测到24.8％的VADA扩大。Cox比例风险模型显示，年轻年龄（风险比0.953，P=0.043）和高信号的存在（风险比2.841，P=0.033）与VADA增大显着相关。
在初次检查后第30天，VADAs扩大了约25％。较年轻的年龄和高信号的存在与VADA扩大显着相关。
在115例未经历蛛网膜下腔出血的单侧颅内椎动脉夹层患者中，64例椎动脉夹层珍珠征（无狭窄的VADA）参与了研究。我们进行了初始磁共振成像以诊断VADA，随后进行了磁共振成像以评估VADA扩大。使用T1加权三维涡轮自旋回波成像确认了高强度壁内信号的存在。通过磁共振血管造影术评估初始和后续检查之间的VADA扩大情况，并将其定义为终点。我们使用Kaplan-Meier曲线分析研究了VADA的扩大率。自变量确定后，Cox比例风险模型应用于多变量分析,以确定与VADA扩大显著相关的因素.
64名患者(平均年龄，55.7±13.0岁；44名男性和20名女性），15展示了VADA扩大。Kaplan-Meier曲线分析表明，在初始磁共振成像后30天检测到24.8％的VADA扩大。Cox比例风险模型显示，年轻年龄（风险比0.953，P=0.043）和高信号的存在（风险比2.841，P=0.033）与VADA增大显着相关。
在初次检查后第30天，VADAs扩大了约25％。较年轻的年龄和高信号的存在与VADA扩大显着相关。
