Circumferential wall enhancement in evolving intracranial aneurysms on magnetic resonance vessel wall imaging

Autor:	Takashi Inoue, Hidenori Endo, Shin Ichiro Sugiyama, Shunsuke Omodaka, Kuniyasu Niizuma, Kenichi Sato, Miki Fujimura, Teiji Tominaga, Toshiki Endo
Rok vydání:	2019
Předmět:	Pituitary stalk medicine.medical_specialty medicine.diagnostic_test business.industry Ruptured aneurysms Magnetic resonance imaging General Medicine Fast spin echo medicine.disease Aneurysm cardiovascular system medicine cardiovascular diseases Radiology Active state business Surgical treatment
Zdroj:	Journal of Neurosurgery. 131:1262-1268
ISSN:	1933-0693 0022-3085
Popis:	OBJECTIVERecent MR vessel wall imaging studies have indicated intracranial aneurysms in the active state could show circumferential enhancement along the aneurysm wall (CEAW). While ruptured aneurysms frequently show CEAW, CEAW in unruptured aneurysms at the evolving state (i.e., growing or symptomatic) has not been studied in detail. The authors quantitatively assessed the degree of CEAW in evolving unruptured aneurysms by comparing it separately to that in stable unruptured and ruptured aneurysms.METHODSA quantitative analysis of CEAW was performed in 26 consecutive evolving aneurysms using MR vessel wall imaging. Three-dimensional T1-weighted fast spin echo sequences were obtained before and after contrast media injection, and the contrast ratio of the aneurysm wall against the pituitary stalk (CRstalk) was calculated as the indicator of CEAW. Aneurysm characteristics of evolving aneurysms were compared with those of 69 stable unruptured and 67 ruptured aneurysms.RESULTSThe CRstalk values in evolving aneurysms were significantly higher than those in stable aneurysms (0.54 vs 0.34, p < 0.0001), and lower than those in ruptured aneurysms (0.54 vs 0.83, p < 0.0002). In multivariable analysis, CRstalk remained significant when comparing evolving with stable aneurysms (odds ratio [OR] 12.23, 95% confidence interval [CI] 3.53–42.41), and with ruptured aneurysms (OR 0.083, 95% CI 0.022–0.310).CONCLUSIONSThe CEAW in evolving aneurysms was higher than those in stable aneurysms, and lower than those in ruptured aneurysms. The degree of CEAW may indicate the process leading to rupture of intracranial aneurysms, which can be useful additional information to determine an indication for surgical treatment of unruptured aneurysms.
Databáze:	OpenAIRE
Externí odkaz:	https://explore.openaire.eu/search/publication?articleId=doi_dedup___::9bf92edcaab0e525675971d6c3dd3b9c https://doi.org/10.3171/2018.5.jns18322 Zobrazit plný text záznamu