常规磁共振T2WI影像可诊断≥5mm颅内动脉瘤OA

Objective To evaluate the diagnostic value of conventional magnetic resonance T2WI for intracranial aneurysms(IAs)≥5 mm,aiming to reduce the rates of missed and uncertain diagnosis.Methods We retrospectively collected magnetic resonance T2WI data of 151 patients with IAs≥5 mm,confirmed by computed tomography angiography(CTA),magnetic resonance angiography(MRA),or digital subtraction angiography(DSA),at Sir Run Run Shaw Hospital,Zhejiang University School of Medicine,from January 2019 to December 2024.A total of 162 IAs from the 151 patients were identified and categorized into a missed-diagnosis group,an uncertain-diagnosis group,and a confirmed-diagnosis group based on diagnostic difficulty.The impacts of aneurysm size,location,and T2-vascular flow void sign on the diagnosis of IAs were analyzed among the three groups.Additionally,the inter-observer agreement between two radiologists was evaluated.Results Among the 162 IAs,the proportions of the missed-diagnosis,uncertain-diagnosis,and confirmed-diagnosis groups were 13.6%(22/162),34.0%(55/162),and 52.4%(85/162),respectively.The aneurysm size in the confirmed-diagnosis group[10.90(8.20,13.15)mm]was significantly larger than that in the uncertain-diagnosis group[6.20(5.60,7.90)mm,P_corr<0.05]and the missed-diagnosis group[5.55(5.18,6.55)mm,P_corr<0.05],while no significant difference was observed between the uncertain and missed diagnosis groups(P_corr=0.397).IAs were predominantly located in the middle cerebral artery,ophthalmic segment of the internal carotid artery,communicating segment of the internal carotid artery,and vertebral artery,with no significant difference in location distribution among the three groups(P=0.825).The proportions of complete versus incomplete T2-vascular flow void sign in the missed-diagnosis,uncertain-diagnosis,and confirmed-diagnosis groups were 72.7%(16/22)vs 27.3%(6/22),67.3%(37/55)vs 32.7%(18/55),and 57.5%(49/85)vs 42.4%(36/85),respectively(P=0.306).Among the 151 patients,subarachnoid hemorrhage occurred in 3 cases.The inter-observer agreement between the two radiologists was excellent(Kappa=0.890,95%CI:0.839～0.941,P<0.05).Conclusion Conventional magnetic resonance T2WI demonstrates potential clinical value in the diagnosis of IAs≥5 mm.Accurate identification of T2WI features of IAs is expected to improve diagnostic accuracy and reduce complications such as subarachnoid hemorrhage.