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논문 기본 정보

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학술저널
저자정보
Chen Peng Roc (Department of Neurosurgery University of Texas McGovern Medical School Houston TX USA) Lopez-Rivera Victor (Department of Neurology University of Texas McGovern Medical School Houston TX USA) Conner Christopher R (Department of Neurosurgery University of Texas McGovern Medical School Houston TX USA) Sanzgiri Aditya (Department of Neurosurgery University of Texas McGovern Medical School Houston TX USA) Sheth Sunil A. (Department of Neurology University of Texas McGovern Medical School Houston TX USA) Erkmen Kadir (Department of Neurosurgery Temple University Philadelphia PA USA) Kim Dong H (Department of Neurosurgery University of Texas McGovern Medical School Houston TX USA) Day Arthur L. (Department of Neurosurgery University of Texas McGovern Medical School Houston TX USA)
저널정보
대한뇌혈관외과학회 Journal of Cerebrovascular and Endovascular Neurosurgery Journal of Cerebrovascular and Endovascular Neurosurgery Vol.23 No.2
발행연도
2021.6
수록면
108 - 116 (9page)
DOI
10.7461/jcen.2021.E2020.10.002

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Objective A high rate of cerebral aneurysm recurrence following endovascular coiling has prompted the use of digital subtraction angiography (DSA) for interval follow-up. However, the utility of skull x-rays as an alternative screening method for aneurysm recurrence is unproperly characterized. Methods Retrospective review of a prospective registry of ruptured and unruptured cerebral aneurysms. Anteroposterior and lateral skull x-rays were obtained immediately at the end of the procedure and at 6-month follow-up. Aneurysm recurrence was defined by comparing post-procedure and 6-month DSA imaging. A true positive was defined as a change in coil mass morphology on at least one projection with aneurysm recurrence on DSA, and a true negative defined as a stable coil mass on both projections and no recurrence on DSA. Receiver operating characteristic area under the curve (AUC) statistics was used to assess the performance of skull x-rays in identifying aneurysm recurrence. Results A total of 118 cerebral aneurysms were evaluated with DSA imaging and skull x-rays. A change in coil mass morphology on one projection of skull x-rays correctly detected all true recurrences with a sensitivity of 100% (95% confidence interval [CI], 91-100%). Skull x-rays failed to identify a stable aneurysm coil mass in 15 cases, with a specificity of 79% (68-88%). Skull x-rays performed with AUC 0.8958 (95% CI, 0.8490-0.9431) in identifying aneurysm recurrence. Conclusions The findings of our study suggest that skull x-rays may represent a low-cost, non-invasive screening tool to rule out aneurysm recurrence, which can potentially aid in decreasing the utilization of DSA in the follow-up of patients with coiled cerebral aneurysms.
#Coil mass #Aneurysm recurrence #Skull x-ray #Digital subtraction angiography

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참고문헌 (26)

참고문헌 신청
Campi A / 2007 / Retreatment of ruptured cerebral aneurysms in patients randomized by coiling or clipping in the International Subarachnoid Aneurysm Trial(ISAT) / Stroke 38(5):1538~1544 google schola Cloft HJ / 1999 / Risk of cerebral angiography in patients with subarachnoid hemorrhage, cerebral aneurysm, and arteriovenous malformation : a meta-analysis / Stroke 30(2):317~320 google schola Connor SE / 2001 / The ability of plain radiography to predict intracranial aneurysm occlusion instability during follow-up of endosaccular treatment with Gugliemi detachable coils / Neuroradiology 43(8):680~686 google schola Cottier JP / 2003 / Follow-up of intracranial aneurysms treated with detachable coils : comparison of plain radiographs, 3D time-of-flight MRA and digital subtraction angiography / Neuroradiology 45(11):818~824 google schola Darsaut TE / 2013 / Barrow ruptured aneurysm trial : 3-year results / J Neurosurg 119(6):1642~1644 google schola

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