Wall enhancement on black-blood MRI is independently associated with symptomatic status of unruptured intracranial saccular aneurysm.
Gadolinium
Intracranial aneurysm
Magnetic resonance imaging
Journal
European radiology
ISSN: 1432-1084
Titre abrégé: Eur Radiol
Pays: Germany
ID NLM: 9114774
Informations de publication
Date de publication:
Dec 2020
Dec 2020
Historique:
received:
02
01
2020
accepted:
01
07
2020
revised:
19
05
2020
pubmed:
16
7
2020
medline:
1
4
2021
entrez:
16
7
2020
Statut:
ppublish
Résumé
This study aims to investigate whether aneurysm wall enhancement (AWE) is independently associated with symptomatic status of unruptured intracranial aneurysms (UIAs). One hundred thirty-nine consecutive patients (67 male, mean age 58 ± 11 years) with 79 symptomatic and 87 asymptomatic UIAs were imaged using black-blood MRI pre- and post-gadolinium contrast administration and 3D DSA. Symptoms related to aneurysms were identified including cranial nerve deficits and headache. AWE grade and area were characterized, and aneurysm size was measured on DSA. Multivariate binary logistic regression analysis was used to identify factors associated with symptoms. Further subgroup analysis was performed for aneurysms size < 10 mm. Symptomatic UIAs had significantly larger aneurysm size (11.2 ± 6.2 mm vs. 6.4 ± 3.3 mm), enhancement grade (1.3 ± 0.6 vs. 0.4 ± 0.6), enhancement area (2.0 ± 0.9 vs. 0.4 ± 0.7), and higher prevalence of thick enhancement (39% vs. 3%) compared with asymptomatic UIAs, all p < 0.001. In multivariate analysis, only AWE area (odds ratio [OR] 6.9, 95% confidence interval [4.0, 11.7]) was independently associated with symptoms. AWE area had an area under curve (AUC) value of 0.888, with 72.2% sensitivity and 92.0% specificity for symptoms, which was superior to aneurysm size (AUC of 0.771, with 75.9% sensitivity and 65.5% specificity). In the subgroup analysis of aneurysms smaller than 10 mm (n = 118), AWE area (OR, 7.0, p < 0.001) remained the only independent risk factor associated with symptoms. Larger AWE area is independently associated with symptomatic UIAs, which may provide additional value to guide UIA management and improve patient outcomes. • Symptomatic intracranial aneurysms are larger and more often demonstrate significant wall enhancement than asymptomatic aneurysms. • Larger wall enhancement area is independently associated with symptomatic intracranial aneurysm.
Identifiants
pubmed: 32666320
doi: 10.1007/s00330-020-07063-6
pii: 10.1007/s00330-020-07063-6
doi:
Substances chimiques
Contrast Media
0
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
6413-6420Subventions
Organisme : NHLBI NIH HHS
ID : K99HL136883
Pays : United States
Organisme : Natural Science Foundation of Liaoning Province
ID : 2019-BS-267
Organisme : NHLBI NIH HHS
ID : K99HL136883
Pays : United States
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