磁共振血管壁成像(MR-VWI)是一种新兴的成像技术,用于评估未破裂颅内动脉瘤(UIA)的进行性风险。与标准评估模型不同,MR-VWI仍然有争议。这项研究旨在进一步确定动脉瘤壁增强(AWE)与动脉瘤稳定性之间的潜在关系。使用“颅内动脉瘤”,“磁共振”,和“增强”作为关键字,相关研究在PubMed中进行了系统搜索,Embase,还有Cochrane,纳入合格的研究进行进一步分析.有13项病例对照研究,4项队列研究,2,678例颅内动脉瘤纳入荟萃分析。结果表明,AWE与颅内动脉瘤破裂相关(OR=35.90,95%CI:15.58至82.75,p<0.001)。生长(OR=6.69,95%CI:2.69至16.63,p<0.001),和症状的存在(OR=14.46,95%CI:9.07至23.05,p<0.001)。这一发现具有很高的诊断价值,但这种相关性可能与动脉瘤大小无关.随访研究的汇总相对风险显示,使用AWE的UIA进展风险约为不使用AWE的3.33倍(RR=3.33,95%CI:2.33至4.78,p<0.001)。此外,汇总结果表明,VWI增强的定量指标与动脉瘤稳定性具有同等的相关性(OR=19.61,95%CI:10.63~36.17,p<0.001).AWE是评估UIAs稳定性的有效成像方法,它可以成为未来预防性治疗小的未破裂颅内动脉瘤的标志,这还有待大样本前瞻性研究的验证。
Magnetic resonance vessel wall imaging (MR-VWI) is an emerging imaging technology used to assess the progressive risk of unruptured intracranial aneurysms (UIAs). Unlike the standard evaluation model, MR-VWI is still debatable. This study aims to further define the potential relationship between aneurysm wall enhancement (AWE) and aneurysm stability. Using \"intracranial aneurysm\", \"magnetic resonance\", and \"enhancement\" as keywords, relevant studies were systematically searched in PubMed, Embase, and Cochrane, and the qualified studies were enrolled for further analysis. There were 13 case-control studies, 4 cohort studies, and 2,678 cases of intracranial aneurysms included in the meta-analysis. It was shown that AWE was correlated with intracranial aneurysm rupture (OR = 35.90, 95% CI: 15.58 to 82.75, p < 0.001), growth (OR = 6.69, 95% CI: 2.69 to 16.63, p < 0.001), and presence of symptoms (OR = 14.46, 95% CI: 9.07 to 23.05, p < 0.001). This finding had a high diagnostic value, but the correlation was probably not independent of aneurysm size. The pooled relative risks of the follow-up studies revealed that the risk of UIA progression was approximately 3.33 times higher with AWE than without AWE (RR = 3.33, 95% CI: 2.33 to 4.78, p < 0.001). In addition, the pooled results demonstrated that quantitative indices of VWI enhancement were equally linked with aneurysm stability (OR = 19.61, 95% CI: 10.63 to 36.17, p < 0.001). AWE is an effective imaging method to assess the stability of UIAs, and it can be a marker for the prophylactic treatment of small unruptured intracranial aneurysms in the future, which remains to be validated by prospective studies with large samples.