Multimodal validation of focal enhancement in intracranial aneurysms as a surrogate marker for aneurysm instability.

Neuroradiology
Naomi LarsenPhilipp Berg

Abstract

Circumferential enhancement on MR vessel wall imaging has been proposed as a biomarker of a higher risk of rupture in intracranial aneurysms. Focal enhancement is frequently encountered in unruptured aneurysms, but its implication for risk stratification and patient management remains unclear. This study investigates the association of focal wall enhancement with hemodynamic and morphological risk factors and histologic markers of wall inflammation and degeneration. Patients with an unruptured middle cerebral artery aneurysm who underwent 3D rotational angiography and 3T MR vessel wall imaging showing focal wall enhancement were included. Hemodynamic parameters were calculated based on flow simulations and compared between enhanced regions and the entire aneurysm surface. Morphological parameters were semiautomatically extracted and quantitatively associated with wall enhancement. Histological analysis included detection of vasa vasorum, CD34, and myeloperoxidase staining in a subset of patients. Twenty-two aneurysms were analyzed. Enhanced regions were significantly associated with lower AWSS, lower maxOSI, and increased LSA. In multivariate analysis, higher ellipticity index was an independent predictor of wall enhancement. H...Continue Reading

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Citations

Jan 14, 2021·Journal of Clinical Medicine·Łukasz ZwarzanyWojciech Poncyljusz
Nov 14, 2020·Current Opinion in Rheumatology·Serdar ArslanOsman Kizilkilic
Mar 12, 2021·Journal of Magnetic Resonance Imaging : JMRI·Mariya S PravdivtsevaNaomi Larsen
Apr 30, 2021·Neurosurgical Review·Hamidreza Rajabzadeh-OghazVincent M Tutino
Jul 13, 2021·Frontiers in Immunology·Tuula Peñate MedinaJan-Bernd Hövener
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Sep 15, 2021·International Journal of Computer Assisted Radiology and Surgery·Franziska GaidzikPhilipp Berg
Sep 17, 2021·Scientific Reports·Ashrita RaghuramEdgar A Samaniego

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Methods Mentioned

BETA
imaging techniques

Software Mentioned

R
STAR
- CCM +
PHASES
MeVisLab
RStudio
XtraVision

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Aneurysm

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