MR-DWI–Positive Lesions and Symptomatic Ischemic Complications After Coiling of Unruptured Intracranial Aneurysms
Authors
Dong-Hun Kang ; Byung Moon Kim ; Dong Joon Kim ; Sang Hyun Suh ; Dong Ik Kim ; Yong-Sun Kim ; Seung Kon Huh ; Jaechan Park ; Jae Whan Lee ; Yong Bae Kim
Age Factors ; Aged ; Aged, 80 and over ; Diffusion Magnetic Resonance Imaging* ; Embolization, Therapeutic/adverse effects* ; Embolization, Therapeutic/instrumentation ; Embolization, Therapeutic/methods ; Female ; Humans ; Incidence ; Intracranial Aneurysm/therapy* ; Ischemic Attack, Transient/epidemiology* ; Ischemic Attack, Transient/pathology* ; Male ; Middle Aged ; Retrospective Studies ; Risk Factors ; Sensitivity and Specificity ; Stroke/epidemiology* ; Stroke/pathology*
Keywords
Age Factors ; Aged ; Aged, 80 and over ; Diffusion Magnetic Resonance Imaging* ; Embolization, Therapeutic/adverse effects* ; Embolization, Therapeutic/instrumentation ; Embolization, Therapeutic/methods ; Female ; Humans ; Incidence ; Intracranial Aneurysm/therapy* ; Ischemic Attack, Transient/epidemiology* ; Ischemic Attack, Transient/pathology* ; Male ; Middle Aged ; Retrospective Studies ; Risk Factors ; Sensitivity and Specificity ; Stroke/epidemiology* ; Stroke/pathology*
Abstract
BACKGROUND AND PURPOSE:
The aims of this study are to evaluate the risk factors for symptomatic ischemic complication (symptomatic ischemic complication [SIC], transient ischemic attack, or stroke) and microembolisms detected as MR diffusion-weighted imaging (MR-DWI)-positive (DWI(+)) lesions, and the relationship between DWI(+) and SIC after coiling of unruptured intracranial aneurysm.
METHODS:
Between March 2009 and November 2011, 382 unruptured intracranial aneurysms in 343 patients underwent both coiling and posttreatment MR-DWI. The incidence of and risk factors for SIC and DWI(+), and the relationship between DWI(+) and SIC were retrospectively analyzed.
RESULTS:
The incidence of SIC was 4.1%. The incidence of DWI(+) was 54.5%. The number of DWI(+) lesions was significantly larger in the SIC group, than in the asymptomatic one (12.1±10.4 versus 5.0±8.7, P<0.00). The cutoff value of DWI(+) for predicting SIC was ≥6 (sensitivity 85.7%, specificity 70.7%). The patients with DWI(+) ≥6 was 28.6%. Of the patients with SIC, the patients with DWI(+) ≥6 was 78.6%. Patients aged≥65 years had a trend for SIC, and it was the only independent risk factor for DWI(+) ≥cutoff (n=6; 95%CI, 1.167-3.083).
CONCLUSIONS:
The number of DWI(+) lesions was significantly larger in the SIC group than in the asymptomatic one after coiling of unruptured intracranial aneurysm. Patients aged≥65 had a trend for SIC, and it was the only independent risk factor for the number of DWI(+) ≥cutoff value (n=6) for predicting SIC.