Correlation between aneurysm wall enhancement shown on high-resolution magnetic resonance imaging and the risk of intracranial aneurysm rupture / 国际脑血管病杂志

ABSTRACT

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.