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Circumferential Thick Enhancement at Vessel Wall MRI Has High Specificity for Intracranial Aneurysm Instability.
Edjlali, Myriam; Guédon, Alexis; Ben Hassen, Wagih; Boulouis, Grégoire; Benzakoun, Joseph; Rodriguez-Régent, Christine; Trystram, Denis; Nataf, François; Meder, Jean-Francois; Turski, Patrick; Oppenheim, Catherine; Naggara, Olivier.
Affiliation
  • Edjlali M; From the Departments of Neuroradiology (M.E., A.G., W.B.H., G.B., J.B., C.R.R., D.T., J.F.M., C.O., O.N.) and Neurosurgery (F.N.), Université Paris Descartes Sorbonne Paris Cité, INSERM S894, DHU Neurovasc, Centre Hospitalier Sainte-Anne, Service Imagerie Morphologique et Fonctionnelle, 1 rue Cabani
  • Guédon A; From the Departments of Neuroradiology (M.E., A.G., W.B.H., G.B., J.B., C.R.R., D.T., J.F.M., C.O., O.N.) and Neurosurgery (F.N.), Université Paris Descartes Sorbonne Paris Cité, INSERM S894, DHU Neurovasc, Centre Hospitalier Sainte-Anne, Service Imagerie Morphologique et Fonctionnelle, 1 rue Cabani
  • Ben Hassen W; From the Departments of Neuroradiology (M.E., A.G., W.B.H., G.B., J.B., C.R.R., D.T., J.F.M., C.O., O.N.) and Neurosurgery (F.N.), Université Paris Descartes Sorbonne Paris Cité, INSERM S894, DHU Neurovasc, Centre Hospitalier Sainte-Anne, Service Imagerie Morphologique et Fonctionnelle, 1 rue Cabani
  • Boulouis G; From the Departments of Neuroradiology (M.E., A.G., W.B.H., G.B., J.B., C.R.R., D.T., J.F.M., C.O., O.N.) and Neurosurgery (F.N.), Université Paris Descartes Sorbonne Paris Cité, INSERM S894, DHU Neurovasc, Centre Hospitalier Sainte-Anne, Service Imagerie Morphologique et Fonctionnelle, 1 rue Cabani
  • Benzakoun J; From the Departments of Neuroradiology (M.E., A.G., W.B.H., G.B., J.B., C.R.R., D.T., J.F.M., C.O., O.N.) and Neurosurgery (F.N.), Université Paris Descartes Sorbonne Paris Cité, INSERM S894, DHU Neurovasc, Centre Hospitalier Sainte-Anne, Service Imagerie Morphologique et Fonctionnelle, 1 rue Cabani
  • Rodriguez-Régent C; From the Departments of Neuroradiology (M.E., A.G., W.B.H., G.B., J.B., C.R.R., D.T., J.F.M., C.O., O.N.) and Neurosurgery (F.N.), Université Paris Descartes Sorbonne Paris Cité, INSERM S894, DHU Neurovasc, Centre Hospitalier Sainte-Anne, Service Imagerie Morphologique et Fonctionnelle, 1 rue Cabani
  • Trystram D; From the Departments of Neuroradiology (M.E., A.G., W.B.H., G.B., J.B., C.R.R., D.T., J.F.M., C.O., O.N.) and Neurosurgery (F.N.), Université Paris Descartes Sorbonne Paris Cité, INSERM S894, DHU Neurovasc, Centre Hospitalier Sainte-Anne, Service Imagerie Morphologique et Fonctionnelle, 1 rue Cabani
  • Nataf F; From the Departments of Neuroradiology (M.E., A.G., W.B.H., G.B., J.B., C.R.R., D.T., J.F.M., C.O., O.N.) and Neurosurgery (F.N.), Université Paris Descartes Sorbonne Paris Cité, INSERM S894, DHU Neurovasc, Centre Hospitalier Sainte-Anne, Service Imagerie Morphologique et Fonctionnelle, 1 rue Cabani
  • Meder JF; From the Departments of Neuroradiology (M.E., A.G., W.B.H., G.B., J.B., C.R.R., D.T., J.F.M., C.O., O.N.) and Neurosurgery (F.N.), Université Paris Descartes Sorbonne Paris Cité, INSERM S894, DHU Neurovasc, Centre Hospitalier Sainte-Anne, Service Imagerie Morphologique et Fonctionnelle, 1 rue Cabani
  • Turski P; From the Departments of Neuroradiology (M.E., A.G., W.B.H., G.B., J.B., C.R.R., D.T., J.F.M., C.O., O.N.) and Neurosurgery (F.N.), Université Paris Descartes Sorbonne Paris Cité, INSERM S894, DHU Neurovasc, Centre Hospitalier Sainte-Anne, Service Imagerie Morphologique et Fonctionnelle, 1 rue Cabani
  • Oppenheim C; From the Departments of Neuroradiology (M.E., A.G., W.B.H., G.B., J.B., C.R.R., D.T., J.F.M., C.O., O.N.) and Neurosurgery (F.N.), Université Paris Descartes Sorbonne Paris Cité, INSERM S894, DHU Neurovasc, Centre Hospitalier Sainte-Anne, Service Imagerie Morphologique et Fonctionnelle, 1 rue Cabani
  • Naggara O; From the Departments of Neuroradiology (M.E., A.G., W.B.H., G.B., J.B., C.R.R., D.T., J.F.M., C.O., O.N.) and Neurosurgery (F.N.), Université Paris Descartes Sorbonne Paris Cité, INSERM S894, DHU Neurovasc, Centre Hospitalier Sainte-Anne, Service Imagerie Morphologique et Fonctionnelle, 1 rue Cabani
Radiology ; 289(1): 181-187, 2018 10.
Article in En | MEDLINE | ID: mdl-29969070
ABSTRACT
Purpose To identify wall enhancement patterns on vessel wall MRI that discriminate between stable and unstable unruptured intracranial aneurysm (UIA). Materials and Methods Patients were included from November 2012 through January 2016. Vessel wall MR images were acquired at 3 T in patients with stable (incidental and nonchanging over 6 months) or unstable (symptomatic or changing over 6 months) UIA. Each aneurysm was evaluated by using a four-grade classification of enhancement 0, none; 1, focal; 2, thin circumferential; and 3, thick (>1 mm) circumferential. Inter- and intrareader agreement for the presence and the grade of enhancement were assessed by using κ statistics and 95% confidence interval (CI). The sensitivity, specificity, and negative and positive predictive values of each enhancement grade for differentiating stable from unstable aneurysms was compared. Results The study included 263 patients with 333 aneurysms. Inter- and intrareader agreement was excellent for both the presence of enhancement (κ values, 0.82 [95% CI 0.67, 0.99] and 0.87 [95% CI 0.7, 1.0], respectively) and enhancement grade (κ = 0.92 [95% CI 0.87, 0.95]). In unruptured aneurysms (n = 307), grade 3 enhancement exhibited the highest specificity (84.4%; 233 of 276; 95% CI 80.1%, 88.7%; P = .02) and negative predictive value (94.3%; 233 of 247) for differentiating between stable and unstable lesions. There was a significant association between grade 3 enhancement and aneurysm instability (P < .0001). Conclusion In patients with intracranial aneurysm, a thick (>1 mm) circumferential pattern of wall enhancement demonstrated the highest specificity for differentiating between stable and unstable aneurysms. © RSNA, 2018.
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Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: Magnetic Resonance Imaging / Image Interpretation, Computer-Assisted / Intracranial Aneurysm Type of study: Observational_studies / Risk_factors_studies Limits: Aged / Female / Humans / Male / Middle aged Language: En Journal: Radiology Year: 2018 Document type: Article
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Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: Magnetic Resonance Imaging / Image Interpretation, Computer-Assisted / Intracranial Aneurysm Type of study: Observational_studies / Risk_factors_studies Limits: Aged / Female / Humans / Male / Middle aged Language: En Journal: Radiology Year: 2018 Document type: Article