Gadolinium Enhancement of the Aneurysm Wall in Extracranial Carotid Artery Aneurysms
| Autor: | C.J.H.M. van Laarhoven, J. Hendrikse, Marjolijn L. Rots, Vanessa E.C. Pourier, G.J. de Borst, Mervyn D.I. Vergouwen, Tim Leiner, N.K.N. Jorritsma |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
Adult
Brain Infarction Carotid Artery Diseases Male medicine.medical_specialty Gadolinium Contrast Media chemistry.chemical_element White matter lesion Asymptomatic 030218 nuclear medicine & medical imaging 03 medical and health sciences 0302 clinical medicine Aneurysm Primary outcome medicine Humans Radiology Nuclear Medicine and imaging cardiovascular diseases Extracranial Vascular Aged Extracranial carotid artery business.industry Reproducibility of Results Middle Aged medicine.disease Magnetic Resonance Imaging Mr imaging Hyperintensity Carotid Arteries chemistry cardiovascular system Female Neurology (clinical) Radiology medicine.symptom business 030217 neurology & neurosurgery |
| Zdroj: | AJNR Am J Neuroradiol |
| ISSN: | 1936-959X 0195-6108 |
| DOI: | 10.3174/ajnr.a6442 |
| Popis: | BACKGROUND AND PURPOSE: The natural history and optimal treatment of extracranial carotid artery aneurysms are unknown. Gadolinium enhancement of the aneurysm wall may reflect aneurysm wall inflammation and instability. In this study, we investigated the feasibility of extracranial carotid artery aneurysm wall imaging and explored a potential relationship of aneurysm wall enhancement with aneurysm growth and the presence of (silent) brain infarcts and white matter lesions. MATERIALS AND METHODS: Fourteen conservatively treated patients with 15 asymptomatic extracranial carotid artery aneurysms underwent gadolinium-enhanced 3T MR imaging at 2 time points with a 12-month interval. Primary outcome was growth of the aneurysm sac (≥2.0 mm); secondary outcomes were the presence of (silent) brain infarcts and white matter lesions at baseline and follow-up. MR images were reviewed by 2 independent observers, and inter- and intraobserver reproducibility was assessed. RESULTS: Seven (50%) patients were men; the median age was 55 years (range, 40–69 years). Eleven extracranial carotid artery aneurysms (73%) were saccular (median size, 11 mm; range, 5.0–38.5 mm), and 4 were fusiform (median size, 21.5 mm; range, 10.0–40.0 mm). Eleven of 15 aneurysms (73%) exhibited gadolinium enhancement at baseline. Four aneurysms (27%) showed growth at follow-up imaging, 2 gadolinium-positive (+) and 2 gadolinium-negative (–) (P = .245). Three patients (21%) had ipsilateral brain infarcts at baseline; 1 of them showed a new silent brain infarct at follow-up imaging (gadolinium+). Nine patients (64%) showed bilateral white matter lesions at baseline. In 3 patients, increased white matter lesion severity was observed at follow-up (2 gadolinium+). All observations showed excellent inter- and intraobserver reproducibility. CONCLUSIONS: In this explorative study, we demonstrated that extracranial carotid artery aneurysm wall imaging was feasible. Future well-powered studies are needed to investigate whether extracranial carotid artery aneurysm gadolinium enhancement predicts aneurysm growth and thromboembolic complications. |
| Databáze: | OpenAIRE |
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