脑动脉瘤可脱落弹簧圈治疗术后随访MRA与DSA的对比研究

MR angiography versus digital subtraction angiography in the follow-up of cerebral aneurysms treated with detachable coils

目的通过与数字血管减影(DSA)对比,评价1.5T的MR血管成像(MRA)在可脱落弹簧圈治疗脑动脉瘤术后随访中的价值。方法65例接受可脱落弹簧圈治疗的患者在栓塞术后3至12个月行DSA和1.5T的MRA检查。MRA图像评价有无动脉瘤的残留,DSA作为参考标准。结果MRA评价动脉瘤残留的敏感性、特异性和准确性分别为80%(95%可信区间(CI):51.9～95.7%),100%(97.5%CI:93.5～100%)和95.7%(95%CI:88.0～99.1%)。阳性和阴性预测率为100%和94.8%。DSA与MRA的评价结果差异没有统计学意义。结论1.5T的MRA是一种准确无创的脑动脉瘤栓塞术后随访的影像学检查方法。

Objective To assess the value of MR angiography （MRA） performed at 1.5T compared with digital subtraction angiography （DSA） for the follow-up of coiltreated cerebral aneurysms. Methods In a prospective study, 65 consecutive patients treated with detachable coils underwent DSA and MRA at 1.5T wtih a follow-up range from 3 to 12 months after coil placement. MRA images were evaluated for presence of aneurysm remnants, and DSA results were considered as a reference standard. Results The sensitivity, specificity, and accuracy of MRA. for the residual aneurysms were 80% （95% confidence interval （CI）： 51.9 - 95.7%）, 100% （97.5% CI： 93.5 - 100%） and 95.7% （95% CI： 88.0 - 99.1%）, respectively. The positive and negative predictive values were 100% and 94.8%, respectively. There was no statistically significant difference in accuracy between MRA and DSA, Conclusion MRA at 1.5T is an accurate and noninvasive imaging examination in the follow-up of patients with cerebral aneurysms treated with coil placement.