Department of Radiology and Biomedical Imaging, UCSF, San Francisco, CA, USA.
Department of Radiology, Changhai Hospital, Shanghai, China.
Eur Radiol. 2018 Dec;28(12):5019-5026. doi: 10.1007/s00330-018-5522-z. Epub 2018 Jun 5.
Aneurysm wall enhancement (AWE) on MRI has been considered an imaging marker to indicate active aneurysm inflammation, but no prospective studies have assessed the ability of AWE to predict rupture risk or growth. We aim to study the association of AWE with traditional risk factors and the estimated rupture risk.
Seventy-seven patients (mean age, 58.4 ± 10.8 years; 57% female) with 88 asymptomatic intracranial saccular aneurysms underwent both 3-T high-resolution MRI and three-dimensional (3D) rotational digital subtraction angiography (DSA). Geometric and morphologic parameters were measured on DSA, and the degree of AWE on MRI was graded. One- and 5-year rupture risks of aneurysms were estimated using the UCAS and PHASES calculator. Parameters associated with AWE were analyzed using uni- and multivariate logistic regression.
Non-internal carotid artery location (OR 3.4, 95% CI 1.6-7.1) and aneurysm size (OR 1.9, 95% CI 1.3-2.7) were independently associated with AWE (p < 0.05). Aneurysms with AWE had significantly higher estimated rupture risk (1 and 5 year, 1.9% and 5.8%) than aneurysms without AWE (0.5% and 2.1%) (p < 0.001). Stronger and larger areas of AWE were correlated with the aneurysm size, size ratio and estimated rupture risk (R ≥ 0.30) (p < 0.01).
Prospective assessment of asymptomatic intracranial aneurysms with MRI suggests that AWE is associated with traditional risk factors and estimated short- and medium-term rupture risk.
• AWE independently associates with aneurysm location and size. • Aneurysms with AWE have higher rupture risk than aneurysms without AWE. • Stronger and larger areas of AWE correlated with the aneurysm size, size ratio and rupture risk.
磁共振成像（MRI）上的瘤壁增强（AWE）被认为是提示动脉瘤炎症活动的影像学标志物，但尚无前瞻性研究评估 AWE 预测破裂风险或生长的能力。我们旨在研究 AWE 与传统危险因素和估计破裂风险的相关性。
77 例（平均年龄 58.4 ± 10.8 岁，57%为女性）88 个无症状颅内囊状动脉瘤患者行 3T 高分辨率 MRI 和三维（3D）旋转数字减影血管造影（DSA）检查。在 DSA 上测量几何和形态参数，并对 MRI 上的 AWE 程度进行分级。使用 UCAS 和 PHASES 计算器估计动脉瘤的 1 年和 5 年破裂风险。使用单变量和多变量逻辑回归分析与 AWE 相关的参数。
非颈内动脉位置（比值比 3.4，95%置信区间 1.6-7.1）和动脉瘤大小（比值比 1.9，95%置信区间 1.3-2.7）与 AWE 独立相关（p<0.05）。有 AWE 的动脉瘤的估计破裂风险明显高于无 AWE 的动脉瘤（1 年和 5 年分别为 1.9%和 5.8%与 0.5%和 2.1%）（p<0.001）。AWE 面积较大和较强与动脉瘤大小、大小比和估计破裂风险相关（R≥0.30）（p<0.01）。
前瞻性评估 MRI 上的无症状颅内动脉瘤表明，AWE 与传统危险因素和估计的短期和中期破裂风险相关。
• AWE 与动脉瘤位置和大小独立相关。• 有 AWE 的动脉瘤破裂风险高于无 AWE 的动脉瘤。• AWE 面积较大和较强与动脉瘤大小、大小比和破裂风险相关。
