From the Department of Neurosurgery (K.Q., J.S., Z.Y., Q.A., P. Liu, P. Li, Y.T., L.Z., W.Z.), Huashan Hospital, Fudan University, Shanghai, China.
Department of Radiology (D.W., L.H.), Huashan Hospital, Fudan University, Shanghai, China.
Stroke. 2019 Jun;50(6):1570-1573. doi: 10.1161/STROKEAHA.118.024195. Epub 2019 Apr 30.
Background and Purpose- High-resolution vessel wall magnetic resonance imaging is a promising technique for assessing wall structures of unruptured intracranial aneurysms (UIAs). However, the relationship between aneurysmal high-resolution vessel wall magnetic resonance imaging features and their histopathologic mechanism remains poorly understood. Methods- From February 2016 to February 2018, a total of 19 men and 28 women with 54 UIAs treated surgically were prospectively enrolled. The intraoperative observed gross pathology of the aneurysmal wall was compared with the enhancement features on high-resolution vessel wall magnetic resonance imaging. Specimens of the UIAs were harvested for histopathologic and immunohistochemistry analysis. Results- An irregular shape and large size was significantly related to UIA wall enhancement. Both uniform and focal wall enhancement may demonstrate the inflammation processes of UIA walls, although the latter may indicate more atherosclerotic plaque formation. Conclusions- Different high-resolution vessel wall magnetic resonance imaging enhancement features may represent variable inflammation status of a UIA wall, which may provide new insights into assessing the UIA wall structure and optimizing treatment.
背景与目的-高分辨率血管壁磁共振成像是评估未破裂颅内动脉瘤（UIAs）血管壁结构的一种很有前途的技术。然而，动脉瘤高分辨率血管壁磁共振成像特征与其组织病理学机制之间的关系仍知之甚少。方法- 2016 年 2 月至 2018 年 2 月，前瞻性纳入了 19 名男性和 28 名女性共 54 例接受手术治疗的 UIAs 患者。将术中观察到的动脉瘤壁大体病理与高分辨率血管壁磁共振成像上的增强特征进行比较。采集 UIAs 标本进行组织病理学和免疫组织化学分析。结果- 不规则形状和大尺寸与 UIA 壁增强显著相关。均匀和局灶性壁增强均可显示 UIA 壁的炎症过程，尽管后者可能表明更多的动脉粥样硬化斑块形成。结论- 不同的高分辨率血管壁磁共振成像增强特征可能代表 UIA 壁的不同炎症状态，这可能为评估 UIA 壁结构和优化治疗提供新的思路。
