Intracranial Aneurysm Enlargement on Serial Magnetic Resonance Angiography

作者：Joseph D. Burns, John Huston, Kennith F. Layton, David G. Piepgras, Robert D. Brown · 发表于：Stroke · 年份：2008 · DOI：10.1161/strokeaha.108.519165 · 被引用次数：138 · 研究领域：Intracranial Aneurysms: Treatment and Complications、Meningioma and schwannoma management、Vascular Malformations Diagnosis and Treatment

BACKGROUND AND PURPOSE: Size of an unruptured intracranial aneurysm (UIA) may be an important risk factor for rupture. Accordingly, serial noninvasive imaging is commonly used to assess untreated UIA for enlargement. Few data exist regarding the frequency and predictors of enlargement. We obtained this information from a group of patients followed with serial MR angiography (MRA). METHODS: We retrospectively identified 165 patients with 191 UIA followed with serial MRA. Fusiform aneurysms, UIA <2 mm, and UIA that were surgically or endovascularly treated before the first MRA were excluded. MRA was performed using 1.5-T and 3-T MRI. Maximal diameter was determined on MRA source images. Multivariate regression analysis was used to determine independent risk factors for growth. RESULTS: Twenty aneurysms (10%) grew over a median follow-up period of 47 months. Frequency of enlargement was 6.9%, 25%, and 83% for aneurysms <8 mm, 8 to 12 mm, and >or=13 mm, respectively (P<0.001 for trend). Of the variables we evaluated, original aneurysm diameter (OR, 1.28 per mm; 95% CI, 1.07 to 1.58) was the only independent predictor of enlargement. Aneurysms >or=8 mm in diameter were at highest risk for enlargement (OR, 7.25; 95% CI, 1.96 to 27.1). There was a trend toward increased risk of enlargement in patients with multiple aneurysms (OR, 2.50; 95% CI, 0.86 to 7.53). CONCLUSIONS: Over a median follow-up period of 47 months, 10% of UIA enlarged. Larger aneurysms had a significantly increased ...