Diagnostic yield of different imaging modalities in the detection rate of intracranial aneurysm remnants after microsurgical clipping – A systematic review and meta-analysis

IF 1.3 Q4 CLINICAL NEUROLOGY
Raphael Sidler , Lukas Andereggen , Gerrit A. Schubert , Basil E. Grüter , Serge Marbacher
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引用次数: 0

Abstract

Objective

While the long-term durability of completely clipped intracranial aneurysms (IA) is excellent, IA with remnants poses a significant risk for future re-growth with subsequent need for long-term follow-up or requirement for retreatment. We aim at reviewing the detection rate of IA remnants after clip ligation in the imaging modalities used to date.

Methods

A systematic review was performed according to the PRISMA guidelines using the PubMed/Medline database. The search terms included “intracranial aneurysm” AND “remnant” either in combination with “digital subtraction angiography” OR “computed tomography angiography” OR “indocyanine green video angiography”.

Results

The overall observed prevalence of IA remnants after clipping was 5.9 %, 10.9 %, 12.5 %, 14.1 % and 28.3 %, using ICG-VA, intraoperative 2D-DSA, CTA, and 3D-DSA, respectively. In studies comparing all imaging modalities altogether, 3D-DSA performed significantly better (p < 0.001) than any other single modality. The diagnostic yield of CTA and DSA gradually improved over time. Irrespective of imaging modality the percentage of IA remnants is higher in ruptured than unruptured IAs.

Conclusion

Although the diagnostic yield of CTA and 2D-DSA have substantially improved over recent years 3D-DSA provides the highest overall detection rate of clipped IA remnants. In direct comparison, 3D-DSA performs better than any other imaging modality.
不同成像模式对显微手术切除后颅内动脉瘤残余物检出率的诊断率--系统回顾和荟萃分析
目的虽然完全夹闭的颅内动脉瘤(IA)的长期耐久性非常好,但有残余物的IA在未来再次生长的风险很大,因此需要长期随访或进行再治疗。我们的目的是回顾迄今为止所使用的成像模式中夹子结扎后颅内动脉瘤残余的检出率。方法根据PRISMA指南,使用PubMed/Medline数据库进行了系统性回顾。检索词包括 "颅内动脉瘤 "和 "残余",可与 "数字减影血管造影 "或 "计算机断层扫描血管造影 "或 "吲哚青绿视频血管造影 "结合使用。在对所有成像模式进行综合比较的研究中,3D-DSA 的表现明显优于任何其他单一模式(p < 0.001)。随着时间的推移,CTA 和 DSA 的诊断率逐渐提高。结论虽然近年来 CTA 和 2D-DSA 的诊断率有了大幅提高,但 3D-DSA 对剪除的 IA 残留物的总体检出率最高。直接比较而言,3D-DSA 的表现优于任何其他成像模式。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Brain Hemorrhages
Brain Hemorrhages Medicine-Surgery
CiteScore
2.90
自引率
0.00%
发文量
52
审稿时长
22 days
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