CE-MRA联合HRMR-VWI技术对颅内“未破”动脉瘤稳定性的评估价值

Evaluated Value of CE-MRA Combined with HRMR-VWI on Stability of Unruptured Intracranial Aneurysms

目的探究增强磁共振血管成像(CE-MRA)和高分辨率磁共振血管壁成像(HRMR-VWI)技术对“未破”颅内动脉瘤(UIA)稳定性的评估价值。方法选取我院60例UIA(共68个瘤灶)患者为研究对象,将PHASES评分>3分者纳入破裂高风险组(n=31),≤3分者纳入破裂低风险组(n=37),比较两组一般资料、影像特征,分析UIA破裂的相关因素及UIA患者影像学参数与PHASES评分的相关性。结果破裂高风险组年龄、高血压、高血脂、ELAPSS评分、瘤体直径≥5mm、多发病灶、形态不规则、含有子囊、体颈比>1.6、瘤体体率>1.6、动脉瘤壁强化占比显著高于破裂低风险组(P<0.05);多因素Logistic回归分析显示,多发病灶、形态不规则、子囊、体颈比、动脉瘤壁强化、ELAPSS评分是影响UIA破裂的危险因素(P<0.05);Spearman相关系数分析显示,多发病灶、形态不规则、子囊、体颈比、动脉瘤壁强化与PHASES评分均呈显著正相关(P<0.05)。结论UIA患者CE-MRA和HRMR-VWI影像学特征性明显,其中多发病灶、形态不规则、子囊、体颈比、动脉瘤壁强化与UIA破裂风险评分均具有显著相关性。

Objective To explore the evaluated value of contrast-enhanced magnetic resonance angiography(CEMRA)combined with high-resolution magnetic resonance vessel wall imaging(HRMR-VWI)on the stability of unruptured intracranial aneurysms(UIA).Methods 60 patients with unruptured UIA(68 lesions in total)in our hospital were selected as the study subjects.Patients with PHASES score>3 points were included in high-risk rupture group(n=31),and patients with PHASES score≤3 points were enrolled as low-risk rupture group(n=37).The general data and imaging features were compared between low-risk rupture group and high-risk rupture group,to analyze the related factors of UIA rupture and the correlation between imaging parameters and PHASES score in UIA patients.Results The age,hypertension,hyperlipidemia,ELAPSS score,tumor diameter≥5 mm,multiple lesions,irregular shape,containing ascus,body-neck ratio>1.6,tumor body rate>1.6,and aneurysm wall enhancement in high-risk rupture group were significantly higher than those in low-risk rupture group(P<0.05).Multivariate Logistic regression analysis showed that multiple lesions,irregular shape,ascus,bodyneck ratio,aneurysm wall enhancement,and ELAPSS score were risk factors for UIA rupture(P<0.05).Spearman correlation coefficient analysis showed that multiple lesions,irregular shape,ascus,bodyneck ratio and aneurysm wall enhancement were significantly positively correlated with PHASES score(P<0.05).Conclusion The imaging features of CE-MRA and HRMR-VWI in UIA patients are obviously characteristic.Multiple lesions,irregular shape,ascus,body-neck ratio,and aneurysm wall enhancement are significantly correlated with UIA rupture risk score.