RESUMO
Objective:To investigate the correlation between aneurysm wall enhancement (AWE) shown on high-resolution magnetic resonance imaging (HR-MRI) and the risk of intracranial aneurysm rupture risk.Methods:Patients with unruptured intracranial aneurysm admitted to the First Affiliated Hospital of Zhengzhou University from October 2014 to October 2019 were enrolled retrospectively. Three-dimensional digital subtraction angiography was used to measure the morphological parameters of aneurysms. HR-MRI was used to evaluate the enhancement mode. Univariate analysis and multivariate logistic regression analysis were used to determine the independent influencing factors of AWE. The 5-year rupture risk of intracranial aneurysms was assessed based on the PHASES score. Spearman rank correlation analysis was used to determine the correlation between the enhancement mode and the risk of aneurysm rupture. Results:A total of 261 patients and 333 unruptured intracranial saccular aneurysms were included. There were significant differences in the proportion of multiple aneurysms, the size and location of aneurysms between the enhanced group and the non-enhanced group (all P<0.05). Multivariate logistic regression analysis showed that after adjusting for confounding factors such as age and gender, multiple aneurysms (odds ratio [ OR] 0.446, 95% confidence interval [ CI] 0.251-0.791; P=0.006), aneurysm size ( OR 1.327, 95% CI 1.218-1.445; P<0.001) and location (anterior cerebral artery/posterior communication artery/posterior circulation: OR 2.058, 95% CI 1.217-3.482; P=0.007) were significantly independently related to AWE. Based on the PHASES score, the 5-year predicted rupture risk of the enhanced group was significantly higher than that of the non-enhanced group (5.2%±6.2% vs. 1.5%±2.0%; P<0.001). Spearman rank correlation analysis showed that there was a significant positive correlation between the extent of aneurysm enhancement and the risk of aneurysm rupture ( r=0.435, P<0.001). Conclusions:AWE shown on HR-MRI is associated with multiple aneurysms, aneurysm size, and location. Application of AWE might predict the risk of rupture of intracranial aneurysms.
RESUMO
Objective To investigate the clinical significance of circumferential aneurysmal wall enhancement (CAWE)in high-resolution magnetic resonance imaging. Methods The imaging and clinical data of 41 patients with intracranial aneurysm underwent gadolinium-enhanced 3. 0 T HR-MRI from October 2014 to July 2015 were analyzed retrospectively. Two experienced neurovascular radiologists read the vascular neuroimagings independently and determined whether the intracranial aneurysm walls of the patents had CAWE. Twenty-five patients had unstable intracranial aneurysms and 16 had stable intracranial aneurysms. The consistency of the diagnostic results of the 2 radiologists was evaluated by the Kappa test. The CAWE,number,location,size and the imaging features of intracranial aneurysms,as well as gender,age, smoking history,drinking history,hypertension and diabetes of clinical risk factors of the patients in both groups were compared. The comparison between groups was conducted by using the chi-square test. Results A total of 47 intracranial aneurysms were detected in 41 patients,including 29 unstable intracranial aneurysms (a unstable aneurysm group)and 18 stable intracranial aneurysms (a stable aneurysm group). The consistency of CAWE results diagnosed by 2 experienced neurovascular radiologists was better (κ =0. 828;95%CI 0. 668 -0. 989). CAWE of the unstable intracranial aneurysms was significantly more than those of the stable intracranial aneurysms. There was significant difference (75. 9%[22 / 29]vs. 33. 33%[6 / 18];χ2 = 8. 341,P = 0. 004). The age of the patients with unstable intracranial aneurysm was younger than 60 years;it was more than those with stable intracranial aneurysm. There was significant difference (68%[17/ 25]vs. 31. 25%[5/ 16];χ2 = 5. 299,P = 0. 021),while there were no significant differences in the imaging features,including the number,location,size,as well as the clinical risk factors,including gender, smoking history,drinking history,hypertension,and diabetes between the 2 groups (P > 0. 05). Conclusion CAWE is significantly more common in unstable intracranial aneurysms. It can differentiate the symptomatic,morphological changes of ruptured intracranial aneurysms between the stable intracranial aneurysms.