改良Raymond-Roy分类评估颅内分叉部动脉瘤血管内治疗效果的一致性  

Consistency of modified Raymond-Roy classification in evaluating the efficacy of endovascular therapy for intracranial bifurcation aneurysms

作　　者：陈力 邓波 刘卫东[3] 顾文权 顾斌贤[1] 顾奕[1] 孟令平[2] 王武[1] CHEN Li;DENG Bo;LIU Weidong;GU Wenquan;GU Binxian;GU Yi;MENG Lingping;WANG Wu(Department of Radiology,Affiliated Sixth People’s Hospital,Shanghai Jiao Tong University,Shanghai 200233,China)

机构地区：[1]上海交通大学附属第六人民医院放射科,200233 [2]上海市第六人民医院金山分院 [3]上海市浦南医院

出　　处：《介入放射学杂志》2020年第10期968-972,共5页Journal of Interventional Radiology

基　　金：国家自然科学基金(81771951);上海市浦东新区医学学科建设项目(PWYgy201804)。

摘　　要：目的评价改良Raymond-Roy分类(MRRC)和Raymond 4级分类评估的观察者间一致性,比较两种分类预测颅内分叉部动脉瘤早期复发的能力。方法回顾性分析2012年1月至2018年12月127例经血管内治疗的颅内分叉部动脉瘤患者临床资料。根据MRRC和Raymond 4级分类,5名经验丰富的神经介入医师独立评估颅内分叉部动脉瘤栓塞术后即刻和随访时血管造影所示栓塞程度。组内相关系数(ICC)确定观察者间评估的一致性。采用受试者工作特征曲线(ROC)分析两种分类预测动脉瘤随访时显著复发的能力。结果术后即刻和随访时血管造影评估显示,MRRC、Roymond 4级分类ICC值分别为0.78、0.80和0.91、0.89。ROC分析显示,MRRC、Roymond 4级分类曲线下面积(AUC)均为0.67。结论MRRC和Raymond 4级分类评估的观察者间一致性相仿且均较优越。两种分类在预测随访时动脉瘤显著复发方面均有良好能力。Objective To evaluate inter-observer consistency in assessing the efficacy of endovascular therapy for intracranial bifurcation aneurysms between the criterion of modified Raymond-Roy classification(MRRC)and the criterion of Raymond 4-level classification,and to compare the ability of two classification methods in predicting early recurrence of intracranial bifurcation aneurysms.Methods The clinical data of127 patients with intracranial bifurcation aneurysm,who received endovascular therapy during the period from January 2012 to December 2018,were retrospectively analyzed.According to MRRC and Raymond 4-level classification,5 experienced neurointervention physicians independently evaluated the embolization degree of intracranial bifurcation aneurysms based on the manifestations of angiography performed immediately after the treatment and in the follow-up period.Intra-group correlation coefficient(ICC)was used to determine the consistency of inter-observer assessment results.By using receiver operating characteristic curve(ROC)the ability of two classification methods in predicting aneurysm recurrence was analyzed.Results Angiographic evaluation conducted immediately after the treatment and in the follow-up period showed that ICC values for MRRC were 0.78 and 0.91 respectively,which were 0.80 and 0.89 respectively for Raymond 4-level classification.ROC analysis indicated that area under the curve(AUC)was 0.67 for both MRRC and Raymond 4-level classification.Conclusion The inter-observer consistency in assessing the efficacy of endovascular therapy for intracranial bifurcation aneurysms by using MRRC or by using the Raymond 4-level classification is much alike and excellent.In predicting obvious recurrence of intracranial bifurcation aneurysms,both MRRC and the Raymond 4-level classification have excellent ability.(J Intervent Radiol,2020,29:968-972)

关 键 词：颅内分叉部动脉瘤 改良Raymond-Roy分类 Raymond分类 观察者间一致性 血管内治疗 

分 类 号：R739.41[医药卫生—肿瘤]