Journal article
3D aneurysm wall enhancement is associated with symptomatic presentation
Journal of neurointerventional surgery, Vol.15(8), pp.747-752
2023
DOI: 10.1136/jnis-2022-019125
PMCID: PMC10173164
PMID: 35853699
Abstract
BackgroundAneurysm wall enhancement (AWE) is a potential surrogate biomarker for aneurysm instability. Previous studies have assessed AWE using 2D multiplanar methods, most of which were conducted qualitatively.ObjectiveTo use a new quantitative tool to analyze a large cohort of saccular aneurysms with 3D-AWE mapsMethodsSaccular aneurysms were imaged prospectively with 3T high resolution MRI. 3D-AWE maps of symptomatic (defined as ruptured or presentation with sentinel headache/cranial nerve neuropathy) and asymptomatic aneurysms were created by extending orthogonal probes from the aneurysm lumen into the wall. Three metrics were used to characterize enhancement: 3D circumferential AWE (3D-CAWE), aneurysm-specific contrast uptake (SAWE), and focal AWE (FAWE). Aneurysms with a circumferential AWE higher than the corpus callosum (3D-CAWE ≥1) were classified as 3D-CAWE+. Symptomatic presentation was analyzed with univariate and multivariate logistic models. Aneurysm size, size ratio, aspect ratio, irregular morphology, and PHASES and ELAPSS scores were compared with the new AWE metrics. Bleb and microhemorrhage analyses were also performed.ResultsNinety-three aneurysms were analyzed. 3D-CAWE, SAWE, and FAWE were associated with symptomatic status (OR=1.34, 1.25, and 1.08, respectively). A multivariate model including aneurysm size, 3D-CAWE+, age, female gender, and FAWE detected symptomatic status with 80% specificity and 90% sensitivity (area under the curve=0.914, =0.967). FAWE was also associated with irregular morphology and high-risk location (p=0.043 and p=0.001, respectively). In general, blebs enhanced 56% more than the aneurysm body. Areas of microhemorrhage co-localized with areas of increased SAWE (p=0.047).Conclusions3D-AWE mapping provides a new set of metrics that could potentially improve the identification of symptomatic aneurysms.
Details
- Title: Subtitle
- 3D aneurysm wall enhancement is associated with symptomatic presentation
- Creators
- Ashrita Raghuram - University of IowaSebastian Sanchez - University of IowaLinder Wendt - Institute for Clinical and Translational Science, The University of Iowa, Iowa City, Iowa, USASteven Cochran - Department of Psychiatry, The University of Iowa Hospitals and Clinics, Iowa City, Iowa, USADaizo Ishii - University of IowaCarlos Osorno - Department of Neurosurgery, The University of Iowa Hospitals and Clinics, Iowa City, Iowa, USAGirish Bathla - Department of Radiology, The University of Iowa Hospitals and Clinics, Iowa City, Iowa, USATimothy R Koscik - University of IowaJames Torner - University of IowaDavid Hasan - Duke UniversityEdgar A Samaniego - Department of Radiology, The University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA
- Resource Type
- Journal article
- Publication Details
- Journal of neurointerventional surgery, Vol.15(8), pp.747-752
- DOI
- 10.1136/jnis-2022-019125
- PMID
- 35853699
- PMCID
- PMC10173164
- NLM abbreviation
- J Neurointerv Surg
- ISSN
- 1759-8478
- eISSN
- 1759-8486
- Publisher
- BMJ Publishing Group Ltd
- Grant note
- UL1TR002537 / National Institutes of Health (http://dx.doi.org/10.13039/100000002)
- Language
- English
- Electronic publication date
- 07/19/2022
- Date published
- 2023
- Academic Unit
- Roy J. Carver Department of Biomedical Engineering; Neurology; Radiology; Psychiatry; Epidemiology; Iowa Neuroscience Institute; Injury Prevention Research Center; Neurosurgery
- Record Identifier
- 9984274946402771
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