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| Predictive Efficacy of MRA in Intracranial Aneurysm Rupture and Hemorrhage and the Value of Evaluating the Patency of the Parent Artery after Operation |
| WANG Hong-juan, DING Meng, WANG Shi-wei,et al |
| Qingdao Central Hospital,Qingdao Shandong 266042 |
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Abstract 【Objective】 To investigate the predictive efficacy of magnetic resonance angiography (MRA) in the rupture and hemorrhage of intracranial aneurysms and to evaluate the patency of the parent artery. 【Methods】A total of 121 patients with intracranial aneurysms treated in our hospital from October 2017 to may 2020 were selected and divided into rupture group (aneurysm rupture and bleeding,n=45) and unruptured group (aneurysm unruptured,n=76) according to the situation of aneurysm rupture and bleeding. The MRA parameters of the two groups were compared [oscillatory shear index (OSI),wall shear stress averaged (WSSA),wall shear stress gradient averaged (WSSGA),normalized surface wall shear stress maximum (NWSSM),low shear stress area ratio (LSAR),normalized surface pressure averaged (NPA)of systolic aneurysms ,normalized one cardiac cycle pressure maximum (NPM)],the influencing factors of intracranial aneurysm rupture and hemorrhage and the predictive value of MRA parameters for intracranial aneurysm rupture and hemorrhage were analyzed. The patients were followed up for 1 year. The value of MRA in evaluating the patency of tumor bearing artery was evaluated by DSA. 【Results】There was no significant difference in WSSA,NPA and NPM between the two groups (P>0.05); The tumor length,width,AR,SR,OSI,WSSGA and LSAR in the ruptured group were higher than those in the unruptured group,and NWSSM was lower than those in the unruptured group (P<0.05). Logistic regression analysis showed that OSI,WSSGA,LSAR and NWSSM were important influencing factors of intracranial aneurysm rupture and hemorrhage (P<0.05); The AUC of OSI,WSSGA,LSAR and NWSSM in predicting intracranial aneurysm rupture and hemorrhage was 0.861,the sensitivity was 80.49%,and the specificity was 84.21%,which was significantly higher than that predicted by the four alone; Kappa consistency analysis showed that MRA and DSA were highly consistent in evaluating the patency of the parent artery (P<0.05). 【Conclusion】 The combination of OSI,WSSGA,LSAR,NWSSM and other parameters measured by MRA is of high value in predicting the rupture and hemorrhage of intracranial aneurysms,and can better evaluate the patency of the parent artery after operation.
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Received: 07 September 2021
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2022, Vol. 39 
