Gadolinium Enhancement of the Aneurysm Wall in Unruptured Intracranial Aneurysms Is Associated with an Increased Risk of Aneurysm Instability: A Follow-Up Study.
Journal
AJNR. American journal of neuroradiology
ISSN: 1936-959X
Titre abrégé: AJNR Am J Neuroradiol
Pays: United States
ID NLM: 8003708
Informations de publication
Date de publication:
07 2019
07 2019
Historique:
received:
08
02
2019
accepted:
14
05
2019
pubmed:
22
6
2019
medline:
23
4
2020
entrez:
22
6
2019
Statut:
ppublish
Résumé
Previous studies have suggested that gadolinium enhancement of the wall of unruptured intracranial aneurysms on MR imaging may reflect aneurysm wall instability. However, all previous studies were cross-sectional. In this longitudinal study, we investigated whether aneurysm wall enhancement is associated with an increased risk of aneurysm instability. We included all patients 18 years of age or older with ≥1 unruptured aneurysm from the University Medical Center Utrecht, the Netherlands, who were included in 2 previous studies with either 3T or 7T aneurysm wall MR imaging and for whom it was decided not to treat the aneurysm but to monitor it with follow-up imaging. We investigated the risk of growth or rupture during follow-up of aneurysms with and without gadolinium enhancement of the aneurysm wall at baseline and calculated the risk difference between the 2 groups with corresponding 95% confidence intervals. We included 57 patients with 65 unruptured intracranial aneurysms. After a median follow-up of 27 months (interquartile range, 20-31 months), growth ( Gadolinium enhancement of the aneurysm wall on MR imaging is associated with an increased risk of aneurysm instability. The absence of wall enhancement makes it unlikely that the aneurysm will grow or rupture in the short term. Larger studies are needed to investigate whether aneurysm wall enhancement is an independent predictor of aneurysm instability.
Sections du résumé
BACKGROUND AND PURPOSE
Previous studies have suggested that gadolinium enhancement of the wall of unruptured intracranial aneurysms on MR imaging may reflect aneurysm wall instability. However, all previous studies were cross-sectional. In this longitudinal study, we investigated whether aneurysm wall enhancement is associated with an increased risk of aneurysm instability.
MATERIALS AND METHODS
We included all patients 18 years of age or older with ≥1 unruptured aneurysm from the University Medical Center Utrecht, the Netherlands, who were included in 2 previous studies with either 3T or 7T aneurysm wall MR imaging and for whom it was decided not to treat the aneurysm but to monitor it with follow-up imaging. We investigated the risk of growth or rupture during follow-up of aneurysms with and without gadolinium enhancement of the aneurysm wall at baseline and calculated the risk difference between the 2 groups with corresponding 95% confidence intervals.
RESULTS
We included 57 patients with 65 unruptured intracranial aneurysms. After a median follow-up of 27 months (interquartile range, 20-31 months), growth (
CONCLUSIONS
Gadolinium enhancement of the aneurysm wall on MR imaging is associated with an increased risk of aneurysm instability. The absence of wall enhancement makes it unlikely that the aneurysm will grow or rupture in the short term. Larger studies are needed to investigate whether aneurysm wall enhancement is an independent predictor of aneurysm instability.
Identifiants
pubmed: 31221634
pii: ajnr.A6105
doi: 10.3174/ajnr.A6105
pmc: PMC7048551
doi:
Substances chimiques
Contrast Media
0
Gadolinium
AU0V1LM3JT
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1112-1116Informations de copyright
© 2019 by American Journal of Neuroradiology.
Références
JAMA Neurol. 2019 Mar 1;76(3):282-293
pubmed: 30592482
World Neurosurg. 2018 Jun;114:e338-e343
pubmed: 29524719
Lancet Neurol. 2014 Jan;13(1):59-66
pubmed: 24290159
Lancet Neurol. 2011 Jul;10(7):626-36
pubmed: 21641282
Clin Neuroradiol. 2016 Sep;26(3):277-83
pubmed: 25332151
J Neurointerv Surg. 2018 Jun;10(6):566-570
pubmed: 28918385
Neurosurgery. 2014 Dec;75(6):614-22; discussion 622
pubmed: 25255252
Neurosurgery. 2018 Oct 1;83(4):692-699
pubmed: 29029314
Neurology. 2017 Apr 25;88(17):1600-1606
pubmed: 28363976
Neurology. 2016 Jan 5;86(1):59-63
pubmed: 26590269
Neurosurgery. 2013 Mar;72(3):492-6; discussion 496
pubmed: 23151622
Stroke. 2014 Dec;45(12):3704-6
pubmed: 25325912
Neurosurgery. 2018 Oct 1;83(4):719-725
pubmed: 29088454
AJNR Am J Neuroradiol. 2018 Apr;39(4):713-719
pubmed: 29472302
Interv Neuroradiol. 2016 Oct;22(5):501-5
pubmed: 27341856
Neuroradiology. 2016 Oct;58(10):979-985
pubmed: 27438805