Performance of Aneurysm Wall Enhancement Compared with Clinical Predictive Scales: PHASES, ELAPSS, and UIATS
| Autor: | David Hasan, Timothy W. Morris, Alberto Varon, Ryan Sabotin, Daizo Ishii, Ashrita Raghuram, Jorge A Roa, Devanshee Patel, Edgar A. Samaniego, Yongjun Lu |
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| Rok vydání: | 2021 |
| Předmět: |
Adult
Male Demographics Logistic regression 03 medical and health sciences 0302 clinical medicine Aneurysm Risk Factors Odds Ratio medicine Humans Aged Aneurysm morphology medicine.diagnostic_test business.industry Confounding Intracranial Aneurysm Magnetic resonance imaging Middle Aged medicine.disease Magnetic Resonance Imaging Cerebral Angiography 030220 oncology & carcinogenesis Blood Vessels Female Surgery Neurology (clinical) Signal intensity Nuclear medicine business 030217 neurology & neurosurgery Statistical correlation |
| Zdroj: | World Neurosurgery. 147:e538-e551 |
| ISSN: | 1878-8750 |
| DOI: | 10.1016/j.wneu.2020.12.123 |
| Popis: | To correlate the presence of objectively measured wall enhancement on high-resolution vessel wall imaging (HR-VWI) with the clinical predictive scales PHASES, ELAPSS, and UIATS.Patients with unruptured intracranial aneurysm (UIAs) prospectively underwent HR-VWI on a 3-T magnetic resonance imaging scanner at diagnosis. Aneurysmal wall enhancement was objectively quantified on T1 postcontrast magnetic resonance imaging using signal intensity values adjusted for the pituitary stalk to calculate a contrast ratio (CROne-hundred and twenty-three patients harboring 178 UIAs underwent HR-VWI. A total of 101 patients with 135 UIAs were analyzed. Enhancing UIAs were larger (8.4 ± 5.5 mm vs. 5.5 ± 2.3 mm; P0.001), had higher aspect ratio (2.3 ± 1.5 vs. 1.8 ± 0.7; P = 0.008), higher size ratio (3.0 ± 1.8 vs. 2.4 ± 1.1; P = 0.016), scored higher on PHASES (5.6 ± 3.9 vs. 4.4 ± 2.6; P = 0.04) and ELAPSS (19.4 ± 8.9 vs. 15.4 ± 7.3; P = 0.006) compared with nonenhancing UIAs. Treatment allocation as defined by UIATS was measured independently to enhancement status. No significant differences were found for UIATS between enhancing and nonenhancing UIAs (P = 0.63). Multivariable regression showed that size was the only independent factor significantly associated with UIA enhancement (odds ratio, 1.76; P = 0.005).Enhancing UIAs score higher in PHASES and ELAPSS scales. This association is largely explained by aneurysm size, aspect, and size ratios. Morphologic UIA features should be accounted for in clinical predictive scales of aneurysm instability. |
| Databáze: | OpenAIRE |
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