Abstract：
BACKGROUND: Unruptured intracranial aneurysms pose a significant clinical and decision-making dilemma. Increase in dome size is one of the crucial indications for treatment. Almost no data exists as to how aneurysms change in size over time.
METHODS: 102 patients (76 women) who had a total of 501 CT examinations were included in the study. Inclusion criteria were: at least three CT angiography studies, an observation period of at least three years, or bleeding during the follow-up period. In each study, the volume of each aneurysm was measured at least four times by two experienced neuroradiologists with the use of dedicated tools. Collected data was used to obtain numerical volume change models for each aneurysm.
RESULTS: 149 aneurysms were analysed in the study (118 in women) No significant differences in location, size or age of observation were detected between men and women. Median follow-up was 5.64 years (IQR 4.17-7.71) and total aneurysm observation time amounted to 964.59 years. There were 57 branching zone aneurysms (women 46), 44 sidewall aneurysms (women 36), 20 anterior communicating artery aneurysms (women 16), 20 posterior communicating artery aneurysms (women 13), and eight posterior circulation aneurysms (women 7). 78 (52%) aneurysms remained stable (women 59), 24 (16.6%) increased their volume (women 20), and five (3.4%) decreased (women 4). In 42 (28%) cases, we observed non-uniform routes of volume changes over surveillance (women 35). In the last group, analysing the whole period of follow-up, 29 (69%) did not change volume (women 24), 11 (26%) grew (women 10), and two decreased in size (4.8%, women 1). Bifurcation zone aneurysms, lower aspect ratio, lower patient age, and higher initial volume were associated with an increased risk of aneurysm growth. Posterior circulation aneurysms presented the lowest rate of volume increase.
CONCLUSIONS: A substantial amount of followed up aneurysms could change volume in a non-uniform way, and an increase in volume may not lead to aneurysm rupture.
METHODS: 102 patients (76 women) who had a total of 501 CT examinations were included in the study. Inclusion criteria were: at least three CT angiography studies, an observation period of at least three years, or bleeding during the follow-up period. In each study, the volume of each aneurysm was measured at least four times by two experienced neuroradiologists with the use of dedicated tools. Collected data was used to obtain numerical volume change models for each aneurysm.
RESULTS: 149 aneurysms were analysed in the study (118 in women) No significant differences in location, size or age of observation were detected between men and women. Median follow-up was 5.64 years (IQR 4.17-7.71) and total aneurysm observation time amounted to 964.59 years. There were 57 branching zone aneurysms (women 46), 44 sidewall aneurysms (women 36), 20 anterior communicating artery aneurysms (women 16), 20 posterior communicating artery aneurysms (women 13), and eight posterior circulation aneurysms (women 7). 78 (52%) aneurysms remained stable (women 59), 24 (16.6%) increased their volume (women 20), and five (3.4%) decreased (women 4). In 42 (28%) cases, we observed non-uniform routes of volume changes over surveillance (women 35). In the last group, analysing the whole period of follow-up, 29 (69%) did not change volume (women 24), 11 (26%) grew (women 10), and two decreased in size (4.8%, women 1). Bifurcation zone aneurysms, lower aspect ratio, lower patient age, and higher initial volume were associated with an increased risk of aneurysm growth. Posterior circulation aneurysms presented the lowest rate of volume increase.
CONCLUSIONS: A substantial amount of followed up aneurysms could change volume in a non-uniform way, and an increase in volume may not lead to aneurysm rupture.
摘要：
背景：未破裂的颅内动脉瘤构成了重大的临床和决策难题。圆顶大小的增加是治疗的关键指征之一。几乎没有关于动脉瘤大小随时间变化的数据。
方法：102名患者（76名女性）共接受了501次CT检查。纳入标准为：至少三项CT血管造影研究，至少3年的观察期,或随访期间出血。在每一项研究中,2名经验丰富的神经放射科医师使用专用工具对每个动脉瘤的体积进行了至少4次测量.收集的数据用于获得每个动脉瘤的数值体积变化模型。
结果：研究中分析了149个动脉瘤（女性118个），在男性和女性之间检测到观察的大小或年龄。中位随访时间为5.64年（IQR4.17-7.71），总动脉瘤观察时间为964.59年。有57个分支区动脉瘤（女性46），44个侧壁动脉瘤（女性36），前交通动脉瘤20例（女性16例），20个后交通动脉瘤（女性13），和8个后循环动脉瘤（女性7）。78（52％）动脉瘤保持稳定（女性59），24人(16.6%)增加了数量(女性20人)，5人(3.4%)减少(女性4人)。在42例(28%)中，我们观察到与监测相比,容量变化的路径不一致(女性35).在最后一组中，分析整个随访期间，29（69%）没有改变体积（女性24），11人（26%）增长（女性10人），和两个面积减少(4.8%，妇女1）。分叉区动脉瘤,较低的纵横比，患者年龄较低，较高的初始体积与动脉瘤生长风险增加相关.后循环动脉瘤的体积增加率最低。
结论：大量随访的动脉瘤可以以不均匀的方式改变体积，体积的增加可能不会导致动脉瘤破裂。
方法：102名患者（76名女性）共接受了501次CT检查。纳入标准为：至少三项CT血管造影研究，至少3年的观察期,或随访期间出血。在每一项研究中,2名经验丰富的神经放射科医师使用专用工具对每个动脉瘤的体积进行了至少4次测量.收集的数据用于获得每个动脉瘤的数值体积变化模型。
结果：研究中分析了149个动脉瘤（女性118个），在男性和女性之间检测到观察的大小或年龄。中位随访时间为5.64年（IQR4.17-7.71），总动脉瘤观察时间为964.59年。有57个分支区动脉瘤（女性46），44个侧壁动脉瘤（女性36），前交通动脉瘤20例（女性16例），20个后交通动脉瘤（女性13），和8个后循环动脉瘤（女性7）。78（52％）动脉瘤保持稳定（女性59），24人(16.6%)增加了数量(女性20人)，5人(3.4%)减少(女性4人)。在42例(28%)中，我们观察到与监测相比,容量变化的路径不一致(女性35).在最后一组中，分析整个随访期间，29（69%）没有改变体积（女性24），11人（26%）增长（女性10人），和两个面积减少(4.8%，妇女1）。分叉区动脉瘤,较低的纵横比，患者年龄较低，较高的初始体积与动脉瘤生长风险增加相关.后循环动脉瘤的体积增加率最低。
结论：大量随访的动脉瘤可以以不均匀的方式改变体积，体积的增加可能不会导致动脉瘤破裂。
