ABSTRACT
Intracranial aneurysms will lead to subarachnoid hemorrhage, which has a high mortality and morbidity risk. Screening high-risk aneurysms for preventive intervention has a positive effect, considering the widespread presence of unruptured aneurysms in the general population, this article reviews the risk factors of aneurysm rupture from the aspects of epidemiology, pathology, morphology and hemodynamics. In terms of epidemiology, smoking history, hypertension, age, gender and family inheritance are all closely related to the risk of aneurysm rupture. In terms of pathology, inflammation on the wall of intracranial aneurysm may be related to the risk of aneurysm rupture. In imaging, the size of intracranial aneurysms, location, the characteristics of the artery wall and some morphological and hemodynamic parameters can be used as evaluation index of fracture risk factors, at the same time the growth of intracranial aneurysm is one of the high risk indicators, the indicators for us in the future to establish intracranial unruptured aneurysms rupture risk factors evaluation model is of great significance.
ABSTRACT
Objective To investigate the feasibility of the arterial wall imaging technology of high-resolution magnetic resonance imaging ( HR-MRI) in the risk assessment of intracranial aneurysm rupture. Methods Fifty-four patients with 66 intracranial aneurysms underwent 3. 0 T HR-MRI multiple sequences arterial wall imaging from November 2013 to March 2015 were analyzed retrospectively. Five patients with ruptured aneurysm were used as a control group. The characteristic differences of aneurysm lesions between an unruptured intracranial aneurysm ( UIA) wall enhancement group and a non-enhancement group were compared. The risk factors for rupture were analyzed according to the size,location, and basic clinical characteristics of aneurysm. Results (1) HR-MRI revealed that whether the aneurysm walls enhanced or not,there were no significant differences in the location size,wide-necked aneurysm or not,and ratios of aneurysm height and neck width (all P >0. 05). (2) The enhancement rates of the aneurysm volume <2 group and ≥2 group were 20%(8/40) and 61. 9%(13/21) respectively,the incidence of the ruptured aneurysm asci was higher than that of UIA,and there was significant difference ( all P<0. 05). There were no significant differences in neck width,rate of aneurysm volume,ratios of aneurysm height and neck width,and enhancement rates among the groups. Conclusion The preliminary results of this study have showed that there is a related trend between the HR-MRI aneurysm wall enhancement and the risk of rupture,but a further large sample follow-up study is needed.
ABSTRACT
OBJECTIVE: The size of intracranial aneurysm has been well known as a risk factor of aneurysmal rupture. The aneurysmal shape affects risk of rupture differently even though the size is similar. Aspect ratio corresponds well with morphologic variability. In this study we investigated the significance of aspect ratio as a predictor of intracranial aneurysm rupture. METHODS: The authors reviewed the retrospectively the medical records of consecutive patients with ruptured and unruptured intracranial aneurysms who underwent cerebral angiography from January 2001 to December 2005. A total of 156 patients underwent cerebral angiography and 171 aneurysms were detected. One hundred forty ruptured and 31 unruptured aneurysms were included. We measured aspect ratio which aneurysmal dome distance and neck width on angiographic images. To compare the difference of size and aspect ratio between ruptured and unrupteured aneurysms, we performed statistical analysis of aspect ratio to obtain the odds ratio(OR) for risk of rupture. RESULTS: The mean aspect ratio was 2.33+/-0.96 for ruptured aneurysms, compared with 1.71+/-0.55 for unruptured aneurysms. The difference of the aspect ratios between ruptured and unruptured groups was statistically significant (p<0.001). The odds ratio of rupture was 6.3 fold greater when the aspect ratio was larger than 2.66 compared with an aspect ratio less than 1.54. CONCLUSION: We suggest that aspect ratio is a significant independent predictor for aneurysmal rupture. The rupture risk was increased significantly when aspect ratio increased.