确定SilentMR血管造影(MRA)在评估支架辅助弹簧圈栓塞治疗的颅内动脉瘤中的有用性。
接受支架辅助线圈栓塞治疗的99例患者(101个动脉瘤)(Neuroformatlas,71例;企业,17;小LVIS,9;和纸牌AB,4例)在栓塞24小时内使用3TMRI系统在同一疗程中进行了飞行时间(TOF)MRA和SilentMRA。两名放射科医生独立地回顾性地解释了两个MRA图像,并使用5点Likert量表对图像质量进行了评级。根据支架设计和动脉瘤部位,进一步比较两种模式在动脉瘤闭塞检测中的图像质量和诊断准确性。
SilentMRA和TOFMRA的平均图像质量得分分别为4.38±0.83和2.78±1.04(p<0.001),一个近乎完美的观察者间协议.沉默MRA在颈内动脉远端的图像质量评分明显高于TOFMRA(n=57,4.25±0.91vs.3.05±1.16,p<0.001),大脑中动脉(n=21,4.57±0.75vs.2.19±0.68,p<0.001),大脑前动脉(n=13,4.54±0.66vs.2.46±0.66,p<0.001),和后循环动脉(n=10,4.50±0.71vs.2.90±0.74,p=0.013)。使用Neuroform图谱时,沉默的MRA在支架动脉中的图像质量评分优于TOFMRA(4.66±0.53vs.3.21±0.84,p<0.001),企业(3.29±1.59vs.1.59±0.51,p=0.003),小LVIS(4.33±1.89vs.1.89±0.78,p=0.033),和SolitaireAB支架(4.00±2.25vs.2.25±0.96,p=0.356)。使用NeuroformAtlas支架时,SilentMRA对动脉瘤闭塞状态的解释显示出比TOFMRA显着更高的敏感性(96.4%vs.14.3%,分别,p<0.001)和LVISJr支架(100%vs.20%,分别,p=0.046)。
无声MRA可用于评估支架辅助线圈栓塞治疗的动脉瘤,无论动脉瘤位置和使用的支架类型。
To determine the usefulness of Silent MR angiography (MRA) for evaluating intracranial aneurysms treated with stent-assisted coil embolization.
Ninety-nine patients (101 aneurysms) treated with stent-assisted coil embolization (Neuroform atlas, 71 cases; Enterprise, 17; LVIS Jr, 9; and Solitaire AB, 4 cases) underwent time-of-flight (TOF) MRA and Silent MRA in the same session using a 3T MRI system within 24 hours of embolization. Two radiologists independently interpreted both MRA images retrospectively and rated the image quality using a 5-point Likert scale. The image quality and diagnostic accuracy of the two modalities in the detection of aneurysm occlusion were further compared based on the stent design and the site of aneurysm.
The average image quality scores of the Silent MRA and TOF MRA were 4.38 ± 0.83 and 2.78 ± 1.04, respectively (p < 0.001), with an almost perfect interobserver agreement. Silent MRA had a significantly higher image quality score than TOF MRA at the distal internal carotid artery (n = 57, 4.25 ± 0.91 vs. 3.05 ± 1.16, p < 0.001), middle cerebral artery (n = 21, 4.57 ± 0.75 vs. 2.19 ± 0.68, p < 0.001), anterior cerebral artery (n = 13, 4.54 ± 0.66 vs. 2.46 ± 0.66, p < 0.001), and posterior circulation artery (n = 10, 4.50 ± 0.71 vs. 2.90 ± 0.74, p = 0.013). Silent MRA had superior image quality score to TOF MRA in the stented arteries when using Neuroform atlas (4.66 ± 0.53 vs. 3.21 ± 0.84, p < 0.001), Enterprise (3.29 ± 1.59 vs. 1.59 ± 0.51, p = 0.003), LVIS Jr (4.33 ± 1.89 vs. 1.89 ± 0.78, p = 0.033), and Solitaire AB stents (4.00 ± 2.25 vs. 2.25 ± 0.96, p = 0.356). The interpretation of the status of aneurysm occlusion exhibited significantly higher sensitivity with Silent MRA than with TOF MRA when using the Neuroform Atlas stent (96.4% vs. 14.3%, respectively, p < 0.001) and LVIS Jr stent (100% vs. 20%, respectively, p = 0.046).
Silent MRA can be useful to evaluate aneurysms treated with stent-assisted coil embolization, regardless of the aneurysm location and type of stent used.