Diagnosis of Cerebral Aneurysm Via Magnetic Resonance Angiography Screening: Emphasis on Legal Responsibility Increases False Positive Rate

Cho, Suhee; Lee, Ji Ye; Ryu, Kyeong-Hwa; Suh, Dae Chul

doi:10.5469/neuroint.2018.13.1.48

Cited by 6 publications

(11 citation statements)

References 19 publications

(27 reference statements)

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“…erefore, this examination was not suitable for patients with ruptured aneurysms and bleeding. Cho et al [15] and Ikawa et al [16] suggested that the lower detection rate of smaller tumors was also a drawback of MRI detection, which was consistent with this finding that CT had a higher detection rate for smaller tumors than MRI (P < 0.05). As a noninvasive examination, the application value of CT has been fully affirmed.…”

Section: Discussionsupporting

confidence: 72%

Comparative Analysis of Low-Rank Matrix Denoising Algorithm-Based MRI and CT Images in Diagnosis of Cerebral Aneurysms

Zheng

et al. 2021

Scientific Programming

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This study aimed to compare the role of magnetic resonance imaging (MRI) and computed tomography (CT) images based on the low-rank matrix (LRM) denoising (LRMD) algorithm in the diagnosis of cerebral aneurysms (CAs). By comparing the role of MRI and CT in the diagnosis of CA, it would be helpful to formulate more reasonable diagnosis strategies and provide a solid foundation for clinical treatment of patients. 80 patients with cerebral aneurysm admitted to hospital were selected as the research objects. First, the LRMD algorithm was established and applied to the image denoising process of MRI and CT. Then, the diagnosis rate of CA by MRI and CT before and after denoising was compared, and the diagnostic rates of the two methods for aneurysms of different sizes were compared. Finally, the location, foci, and patient satisfaction of the aneurysm were compared. The results showed that the MRI and CT images after denoising with LRM were clearer, and the secondary structures in the brain were more obvious. It meant that LRMD had good image denoising effect. The diagnostic rate of denoised MRI and CT was improved. Although the difference was not statistically notable, the diagnostic rate of CT was obviously higher in contrast to MRI ( P < 0.05 ). The diagnostic rate of CT for smaller aneurysms (<3 mm and 3–5 mm) was also notably higher in contrast to MRI ( P < 0.05 ). However, there was no difference in the diagnosis of tumor location between the two. The clarity of CT diagnostic images was better than MRI ( P < 0.05 ). Accordingly, patients were more satisfied with CT in contrast to MRI ( P < 0.05 ). In summary, CT images based on the LRMD algorithm were superior to MRI in the diagnosis of CA, and it could provide more accurate diagnosis results.

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Section: Discussionsupporting

confidence: 72%

Comparative Analysis of Low-Rank Matrix Denoising Algorithm-Based MRI and CT Images in Diagnosis of Cerebral Aneurysms

Zheng

et al. 2021

Scientific Programming

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“…Therefore, a variable degree of anxiety is commonly observed after diagnosis, depending on the emotional response of the physician who explains the risk to the patient and recommends treatment to relieve anxiety, especially in women [ 22 ]. Recent increases in health checkups in the Korean population has meant that more young people undergo brain MRA, which results in the detection of more aneurysms [ 2 23 ]. Once detected, patients often try to seek solutions to relieve their anxiety and fear, and sometimes urge the clinician to perform invasive catheter angiography to treat the aneurysm [ 22 ].…”

Section: Discussionmentioning

confidence: 99%

“…Many patients with unruptured intracranial aneurysm (UIA), diagnosed with aneurysm upon routine checkup, fear the risk of rupture and describe aneurysm as a “ticking time bomb” although such terms should be avoided [ 1 ]. Therefore, the care provider traditionally takes up the responsibility of explaining the actual risk of rupture and taking legal protection against any unexpected risk of adverse events, if surgery is performed, until recovery after the treatment, as the risk of surgical clipping is relatively high [ 2 ].…”

Section: Introductionmentioning

confidence: 99%

Outpatient Day-Care Management of Unruptured Intracranial Aneurysm: A Retrospective Cohort Study

et al. 2022

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Objective This study aimed to assess the outcomes of outpatient day-care management of unruptured intracranial aneurysm (UIA), and to present the risks associated with different management strategies by comparing the outcomes and adverse events between outpatient day-care management and management with longer admission periods. Materials and Methods This retrospective cohort study used prospectively registered data and was approved by a local institutional review board. We enrolled 956 UIAs from 811 consecutive patients (mean age ± standard deviation, 57 ± 10.7 years; male:female = 247:564) from 2017 to 2020. We compared the outcomes after embolization among the different admission-length groups (1, 2, and ≥ 3 days). The outcomes included pre- and post-modified Rankin Scale (mRS) scores and rates of adverse events, cure, recurrence, and reprocedure. Events were defined as any cerebrovascular problems, including minor and major stroke, death, or hemorrhage. Results The mean admission period was 2 days, and 175 patients (191 aneurysms), 551 patients (664 aneurysms), and 85 patients (101 aneurysms) were discharged on the day of the procedure, day 2, and day 3 or later, respectively. During the mean 17-month follow-up period (range 6–53 months; 2757 patient years), no change in post-mRS was observed compared to pre-mRS in 99.6% of patients. Cure was achieved in 95.6% patients; minimal recurrence that did not require re-procedure occurred in 3.5% patients, and re-procedure was required in 2.3% (22 of 956) patients due to progressive enlargement of the recurrent sac during follow up (mean 17 months, range, 6–53 months). There were eight adverse events (0.8%), including five cerebrovascular (two major stroke, two minor strokes and one transient ischemic stroke), and three non-cerebrovascular events. Statistical comparison between groups with different admission lengths (1, 2, and ≥ 3 days) revealed no difference in the outcomes. Conclusion This study revealed no difference in outcomes and adverse events according to the admission period, and suggested that UIA could be managed by outpatient day-care embolization.

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“…Digital subtraction angiography (DSA) remains the gold standard for diagnosis of cerebral aneurysm. Additionally, CT angiography (CTA) and magnetic resonance angiography (MRA) have also been widely proven as reliable tools for aneurysm detection (8,9). Previous researches have displayed that the prevalence of coexisting IA in patients with intracranial tumor ranges from 2.3 to 7.7% (5,10), of which, meningioma and pituitary adenoma were considered as the most frequent brain tumors in relation to higher occurrence of cerebral aneurysm (10,11), predominantly unruptured aneurysms.…”

Section: Introductionmentioning

confidence: 99%

Higher Prevalence and Age Susceptibility of Intracranial Aneurysm in Patients With Acoustic Neuroma

You

Bai

et al. 2020

Front. Neurol.

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Introduction: The purpose of this study was to verify whether the prevalence of intracranial aneurysm (IA) in patients with acoustic neuroma is greater than that in age-and sex-matched controls and to evaluate the independent risk factors related to the occurrence of IA. Methods: We retrospectively analyzed 231 patients diagnosed with acoustic neuroma at our institute between 2015 and 2019 and 489 controls from the medical examination center. Cerebrovascular angiography was acquired from all subjects to assess the presence of IA or not. The prevalence of IA and risk factors associated with a higher IA occurrence were compared, respectively. Results: Cerebral aneurysms were detected in 23 patients (10.0%) and 11 controls (2.2%). The prevalence of IA was significantly different between patients with acoustic neuroma and controls (p < 0.001), and the difference was mainly reflected in the age of 50 and above. In the subgroup analysis, there were distinct differences in several clinical features including age, hypertension, and tumor volume, and cystic change between patients coexisted with IA or not. However, age was a unique independent risk factor for coexistence of IA in patients with acoustic neuroma after multivariate logistic regression (OR 1.050, 95% CI 1.008-1.093, p = 0.019). Conclusions: Our results demonstrate that patients with acoustic neuroma have a higher prevalence of IA than the general population. Older age is correlated with greater occurrence of IA in these patients.

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Diagnosis of Cerebral Aneurysm Via Magnetic Resonance Angiography Screening: Emphasis on Legal Responsibility Increases False Positive Rate

Cited by 6 publications

References 19 publications

Comparative Analysis of Low-Rank Matrix Denoising Algorithm-Based MRI and CT Images in Diagnosis of Cerebral Aneurysms

Comparative Analysis of Low-Rank Matrix Denoising Algorithm-Based MRI and CT Images in Diagnosis of Cerebral Aneurysms

Outpatient Day-Care Management of Unruptured Intracranial Aneurysm: A Retrospective Cohort Study

Higher Prevalence and Age Susceptibility of Intracranial Aneurysm in Patients With Acoustic Neuroma

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