Diagnosis And Rupture Risk Assessment Of Intracranial Aneurysm

Objective: The purpose of our study is comparatively studying the diagnostic value of intracranial aneurysms between VCTDSA and three dimension-digital subtraction angiography (3D-DSA).Methods:Retrospectively analyzed imaging data that patients from July to February2012of suspected intracranial aneurysms with VCTDSA and3D-DSA,the time between the two methods was no more than a week.74patients,31men,43women, average age was48.3.VCTDSA and3D-DSA were reviewed by two independent blinded readers (reviewer A and reviewer B),detected aneurysms number,location and size,respectively. Sensitivity, specificity, and positive and negative predictive values for aneurysm detection with VCTDSA were calculated by3D-DSA and embolization findings as the reference standard. And evaluate agreement between two reviewers with two kind of examination method according to aneurysm detection using kappa coefficient. Results: Diagnosed94aneurysms,3D-DSA detected94,VCTDSA detected93(reviewer A detected93,reviewer B detected92).According to Reviewer A,the sensitivity, specificity, positive predictive value (PPV),and negative predictive value (NPV) of VCTDSA were98.9%、100%、100%and92.9%, respectively; for aneurysms smaller than3mm,the sensitivity, specificity, PPV and NPV of VCTDSA were96.7%,100%,100%and92.9%.According to Reviewer B,the sensitivity, specificity, PPV and NPV of VCTDSA were97.9%,100%,100%and86.7%, respectively; for aneurysms smaller than3mm,the sensitivity, specificity, PPV and NPV of VCTDSA were93.3%,100%,100%and86.7%.However, the sensitivity and specificity were both100%for aneurysms larger than3mm.DSA and VCTDSA detected aneurysm according to number,location and size were very good agreement between the two reviewers (к value were0.97,0.99and0.82)Conclusion:Compared with3D-DSA, VCTDSA has similar diagnostic efficiency of aneurysms detection,it can be used as ccurate method of intracranial aneurysms diagnosis. Objective:The mortality and morbidity of intracranial aneurysm ruptured is extremely high,clinical doctors always fall into a dilemma of how to deal with aneurysms.Many studies show that aneurysm rupture has a direct relationship with morphological features,so we make the research to explore the relationship between the morphology characteristic and risk of cerebral aneurysms and calculate the risk of rupture.Methods:Retrospective analyzed clinical data154patients from December,2009to June,2011of194intracranial aneurysms,58men,96women,average age was57.9.112unruptured and82ruptured,three-dimensional geometries were evaluated for a range of morphological parameters.The parameters include depth,neck width,aspect ratio (AR),shap,have daughter sac or not,number and position distribution of daughter sac.Results:The mean depth,neck width and aspect ratio (AR) of the patients with ruptured and unruptured aneurysms were (4.95±4.80)mm and (2.75±2.65)mm,(3.55±3.10)mm and (2.85±1.90)mm,(1.21±0.68) and (0.96±0.55).The critical depth,neck width and aspect ratio (AR) of the risk of ruptured for intracranial aneurysms were3.65mm,3.35mm and1.135.Those three of the parameters were significantly statiatical different between the ruptured and unruptured group (P<0.05).47.6%of ruptured aneurysms have daughter sac,thus85.7%of unruptured aneurysms have no daughter sac.More ruptured aneurysms are saccular (37.8%), and more unruptured aneurysms are taper (61.6%)Conclusions:The mean depth,neck width and aspect ratio (AR) are useful in predicting the risk of ruptured for intracranial aneurysms and may be have relationship with aneurysms ruptured.And daughter sac has relationship with aneurysms ruptured,number and position distribution of daughter sac have no significance.More ruptured aneurysms are saccular, and more unruptured aneurysms are taper.