MRA技术在破裂颅内动脉瘤诊断及术后复发预测效能中的应用价值

doi:10.7517/issn.1674-0475.210115

摘要/Abstract

摘要： 选取颅内动脉瘤（IA）破裂患者45例为破裂组，同期IA未破裂患者81例为未破裂组，均接受磁共振血管成像（MRA）技术检查及血管内栓塞术治疗，并根据术后3个月有无复发情况分为复发者和无复发者进行对比研究。结果发现，动脉瘤最长径与瘤颈宽度比值（AR）、标准化表面最大剪切力（NWSSM）、剪切力震荡指数（OSI）联合诊断IA破裂的AUC值最大；动脉瘤大小、即刻栓塞效果、AR、NWSSM、OSI是IA术后复发的重要影响因素；AR、NWSSM、OSI联合预测IA术后复发的敏感度、特异度分别为76.47%、90.83%。提示采用MRA技术监测IA形态学与血流动力学，可为临床诊断IA破裂、预测术后复发提供科学循证指导。

关键词: 磁共振血管成像, 颅内动脉瘤, 动脉瘤最长径, 血流动力学, 复发

Abstract: A total of 45 patients with intracranial aneurysm (IA) rupture were selected as the rupture group, and 81 patients with unruptured IA during the same period were selected as the unruptured group. All patients received magnetic resonance angiography (MRA) technical examination and endovascular embolization treatment. The patients were divided into relapsers and non-relapsers according to whether there was relapse at 3 months after operation. The results showed that the AUC of IA rupture diagnosed by the aspect ratio (AR) of the tumor, the normalized wall shear stress maximum(NWSSM), and the oscillating shear index (OSI) was the highest. The size of aneurysm, the effect of immediate embolization were important factors influencing recurrence after IA, as well as the AR, NWSSM and OSI. The sensitivity and specificity of the combination of AR, NWSSM and OSI in predicting postoperative recurrence of IA were 76.47% and 90.83%, respectively. It is suggested that the application of MRA technology to monitor the morphology and hemodynamics of IA can provide scientific evidence-based guidance for clinical diagnosis of IA rupture and prediction of postoperative recurrence.

Key words: magnetic resonance angiography, intracranial aneurysm, longest diameter of aneurysm, hemodynamics, recurrence

黎丽, 孟志华, 刘干辉. MRA技术在破裂颅内动脉瘤诊断及术后复发预测效能中的应用价值[J]. 影像科学与光化学, 2021, 39(5): 678-683.

LI Li, MENG Zhihua, LIU Ganhui. The Application Value of MRA Technique in the Diagnosis of Ruptured Intracranial Aneurysm and the Predictive Performance of Postoperative Recurrence[J]. IMAGING SCIENCE AND PHOTOCHEMISTRY, 2021, 39(5): 678-683.

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