Wall Enhancement, Hemodynamics, and Morphology in Unruptured Intracranial Aneurysms with High Rupture Risk.
Hemodynamics
Intracranial aneurysms
Morphology
Vessel wall imaging
Journal
Translational stroke research
ISSN: 1868-601X
Titre abrégé: Transl Stroke Res
Pays: United States
ID NLM: 101517297
Informations de publication
Date de publication:
10 2020
10 2020
Historique:
received:
13
08
2019
accepted:
09
01
2020
revised:
31
12
2019
pubmed:
22
1
2020
medline:
20
7
2021
entrez:
22
1
2020
Statut:
ppublish
Résumé
The purpose of this study is to investigate the relationship between morphology, hemodynamics, and aneurysm wall enhancement (AWE) on vessel wall MRI and their potential role in rupture of intracranial aneurysms. Fifty-seven patients (22 males and 35 females; mean age of 58.4) harboring 65 unruptured intracranial aneurysms were retrospectively recruited. Vessel wall MRI images were reviewed and differentiated as no (NAWE), partial (PAWE), and circumferential (CAWE) wall enhancement. Computational geometry and computational fluid dynamics were used to calculate morphological and hemodynamic parameters. The PHASES score was calculated for each case to estimate its rupture risk. Univariate and multivariate logistic regression analysis was performed to investigate the relationship between morphological-hemodynamic pattern and AWE as well as their association with rupture risk. AWE was present in 26 (40.0%) lesions, including 14 (21.5%) PAWE and 12 (18.5%) CAWE. Aneurysm size (odds ratio = 7.46, 95% confidence interval = 1.56-35.77, p = 0.012), size ratio (odds ratio = 12.90, 95% confidence interval = 2.28-72.97, p = 0.004), and normalized wall shear stress (odds ratio = 0.11, 95% confidence interval = 0.02-0.69, p = 0.018) were independently associated with the presence of AWE. With increasing PHASES score, size-related parameters and the frequency of irregular shape increased significantly, and a hemodynamic pattern of lower and oscillating wall shear stress was observed. Simultaneously, the proportion of NAWE aneurysms decreased, and PAWE and CAWE aneurysms increased significantly (p < 0.001). Unruptured intracranial aneurysms with a higher rupture risk presented with a significantly larger size, lower wall shear stress, and more intense AWE, which might support the interaction between morphology, hemodynamics, and inflammation and their potential role in aneurysm rupture prediction.
Identifiants
pubmed: 31960286
doi: 10.1007/s12975-020-00782-4
pii: 10.1007/s12975-020-00782-4
pmc: PMC7495996
doi:
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
882-889Subventions
Organisme : National Research and Development Project of Key Chronic Diseases
ID : 2016YFC1300700
Pays : International
Organisme : National Natural Science Foundation of China
ID : 81701775
Pays : International
Organisme : National Natural Science Foundation of China
ID : 81571118
Pays : International
Organisme : National Natural Science Foundation of China
ID : 81771264
Pays : International
Commentaires et corrections
Type : CommentIn
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