医学
改良兰金量表
动脉瘤
优势比
外科
入射(几何)
剪裁(形态学)
放射科
队列
内科学
缺血性中风
缺血
语言学
光学
物理
哲学
作者
Lingli Hu,Kai Quan,Yuan Shi,Peixi Liu,Jianping Song,Ye Tian,Qingzhu An,Yingjun Liu,Sichen Li,Guangrong Yu,Zhiyuan Fan,Jianfeng Luo,Yuxiang Gu,Bin Xu,Wei Zhu,Ying Mao
出处
期刊:Neurosurgery
[Oxford University Press]
日期:2022-11-10
卷期号:92 (2): 421-430
被引量:1
标识
DOI:10.1227/neu.0000000000002219
摘要
BACKGROUND: MR vascular wall imaging (VWI) may have prognostic value in patients with unruptured intracranial aneurysms (UIAs). OBJECTIVE: To evaluate the value of VWI as a predictor of surgical outcome in patients with UIAs. METHODS: This prospective cohort study evaluated surgical outcomes in consecutive patients with UIAs who underwent surgical clipping at a single center. All participants underwent high-resolution VWI and were followed for at least 6 months. The primary clinical outcome was modified Rankin scale (mRS) score 6 months after surgery. RESULTS: The number of patients in the no wall enhancement, uniform wall enhancement (UWE), and focal wall enhancement (FWE) groups was 37, 145, and 154, respectively. Incidence of postoperative complications was 15.5% in the FWE group, 12.4% in the UWE group, and 5.4% in the no wall enhancement group. The proportion of patients with mRS score >2 at the 6-month follow-up was significantly higher in the FWE group than in the UWE group (14.3% vs 6.9%; P = .0389). In the multivariate analysis, FWE (odds ratio, 2.573; 95% CI 1.001-6.612) and positive proximal artery remodeling (odds ratio, 10.56; 95% CI 2.237-49.83) were independent predictors of mRS score >2 at the 6-month follow-up. CONCLUSION: Preoperative VWI can improve the surgeon's understanding of aneurysm pathological structure. Type of aneurysmal wall enhancement on VWI is associated with clinical outcome and incidence of salvage anastomosis and surgical complications.
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