Open AccessFeatures of “false positive” unruptured intracranial aneurysms on screening magnetic resonance angiography
Author(s) -
Minsu Jang,
Jang Hun Kim,
Jin Woo Park,
Haewon Roh,
Han-Joo Lee,
Junghan Seo,
Sung Hwan Hwang,
Joon Yoon,
San-Hyun Yoon,
Byung-Kyu Cho
Publication year - 2020
Publication title -
plos one
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.99
H-Index - 332
ISSN - 1932-6203
DOI - 10.1371/journal.pone.0238597
Subject(s) - digital subtraction angiography , medicine , aneurysm , radiology , receiver operating characteristic , univariate analysis , magnetic resonance imaging , multivariate analysis , magnetic resonance angiography , logistic regression , angiography , subtraction , univariate , computed tomography angiography , nuclear medicine , multivariate statistics , statistics , arithmetic , mathematics
Background Physicians can find it challenging to decide whether confirmative digital subtraction angiography (DSA) should be performed in patients who present with “suspicious small aneurysm-like structures” on magnetic resonance angiography (MRA). Factors associated with “false positive aneurysms on MRA” (FPAMs),” which are finally confirmed as negative on DSA, have rarely been reported. This study aimed to identify the clinical or radiologic clues indicative of FPAM on DSA. Methods Patients who had undergone DSA between 2016 and 2019 for suspicious aneurysm-like structures < 5 mm in size on MRA were enrolled. Patient demographics and the details regarding the geometry of the structures were retrospectively reviewed. Univariate and multivariate logistic regression analyses were conducted to identify the associated factors. Receiver operating characteristic curve analysis was performed to assess the clinical implications. Results Of the 107 suspicious structures, 46 were indicated as being false positive on DSA (42.96%). Location (positive on C7 and negative on C5-6 ICA) and lower dome to neck ratio were found to be significant parameters in the multivariate analysis. The dome to neck ratio threshold value was 0.99. Conclusion Suspicious aneurysm-like structures located not on C5-6 but on C7 ICA and having wide neck morphologies (dome to neck ratio < 0.99) are highly likely to be negative on DSA.