Longitudinal follow up of coiled intracranial aneurysms: the impact of contrast enhanced MRA in comparison to 3DTOF MRA at 3T
Notice bibliographique
Résumé
The role of 3DTOF MRA in the follow up (FU) of coiled cerebral aneurysms is well established. Though CEMRA (Contrast Enhanced Magnetic Resonance Angiography) has demonstrated to be superior to 3DTOF MRA in showing aneurysms residual patency, its role is still debated. The aim of this study was to verify if there is an added value of CEMRA in the long term follow up of coiled treated aneurysms. Sixty-four cerebral aneurysms treated with GDC coils regularly followed up with 3DTOF and CEMRA at 3T every year for at least four years were included in the study. Both MR exams were evaluated and scored according to Montreal scale. Residual patency rates and modifications during follow up as depicted by the two techniques on the three item score of the Montreal scale (TO = total occlusion, NR = neck remnant and AR = aneurysm remnant) were registered along with management decisions. Intertechnique agreement was evaluated with respect to patency scoring in earlier and later stages of FU. Moreover the predictive value of earlier scores for both acquisitions with respect to management decision was assessed. At 1 year FU, TO to NR to AR score ratios were 31/23/10 and 22/31/11 for 3DTOF and CEMRA respectively, whereas at 4 years FU they evolved to 28/22/14 and 19/28/17 respectively. Fifteen patencies (all AR) out of 64 aneurysms were judged suitable of retreatment evaluation during FU and 8 retreatments were effectively performed after overall benefit/risk ratio considerations. All 15 reopenings were equally depicted by both techniques except one that was depicted earlier on CEMRA. Among the 9 TO at TOF MRA and NR at CEMRA at 1 year, 3 cases enlarged to NR at TOF at 4 years, most remained stable. Among the 22 cases judged NR at 1 years with both techniques, 3 cases showed enlargement at both techniques, while in other 3 cases AR was evident only at 3DCEMRA and they were not retreated. CEMRA superiority in depiction of intracranial aneurysms recanalization is confirmed by our data. Nevertheless a clear impact in patient management is apparently not evident. Evidence of occlusion at 3DTOF FU may not need the addition of a CEMRA study.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,002 | 0,006 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,001 | 0,000 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».