Veeturi Sricharan S, Rajabzadeh-Oghaz Hamidreza, Pintér Nándor K, Waqas Muhammad, Hasan David M, Snyder Kenneth V, Siddiqui Adnan H, Tutino Vincent M
Canon Stroke and Vascular Research Center, University at Buffalo, Buffalo, NY, USA.
Department of Mechanical and Aerospace Engineering, University at Buffalo, Buffalo, NY, USA.
R Soc Open Sci. 2021 Nov 10;8(11):211119. doi: 10.1098/rsos.211119. eCollection 2021 Nov.
Vessel wall enhancement (VWE) in contrast-enhanced magnetic resonance imaging (MRI) is a potential biomarker for intracranial aneurysm (IA) risk stratification. In this study, we investigated the relationship between VWE features, risk metrics, morphology and hemodynamics in 41 unruptured aneurysms. We reconstructed the IA geometries from MR angiography and mapped pituitary stalk-normalized MRI intensity on the aneurysm surface using an in-house tool. For each case, we calculated the maximum intensity (CR) and IA risk (via size and the rupture resemblance score (RRS)). We performed correlation analysis to assess relationships between CR and IA risk metrics (size and RRS), as well as each parameter encompassed in RRS, i.e. aneurysmal size ratio (SR), normalized wall shear stress (WSS) and oscillatory shear index. We found that CR had a strong correlation (Pearson correlation coefficient, PCC = 0.630) with size and a moderate correlation (PCC = 0.472) with RRS, indicating an association between VWE and IA risk. Furthermore, CR had a weak negative correlation with normalized WSS (PCC = -0.320) and a weak positive correlation with SR (PCC = 0.390). Local voxel-based analysis showed only a weak negative correlation between normalized WSS and contrast-enhanced MRI signal intensity (PCC = -0.240), suggesting that if low-normalized WSS induces enhancement-associated pathobiology, the effect is not localized.
对比增强磁共振成像（MRI）中的血管壁强化（VWE）是颅内动脉瘤（IA）风险分层的一种潜在生物标志物。在本研究中，我们调查了41个未破裂动脉瘤的VWE特征、风险指标、形态和血流动力学之间的关系。我们从磁共振血管造影重建了IA的几何形状，并使用内部工具将垂体柄标准化的MRI强度映射到动脉瘤表面。对于每个病例，我们计算了最大强度（CR）和IA风险（通过大小和破裂相似性评分（RRS））。我们进行了相关性分析，以评估CR与IA风险指标（大小和RRS）之间的关系，以及RRS中包含的每个参数，即动脉瘤大小比（SR）、归一化壁面切应力（WSS）和振荡切变指数。我们发现CR与大小有很强的相关性（皮尔逊相关系数，PCC = 0.630），与RRS有中等相关性（PCC = 0.472），表明VWE与IA风险之间存在关联。此外，CR与归一化WSS有较弱的负相关性（PCC = -0.320），与SR有较弱的正相关性（PCC = 0.390）。基于局部体素的分析显示，归一化WSS与对比增强MRI信号强度之间仅存在较弱的负相关性（PCC = -0.240），这表明如果低归一化WSS诱导与强化相关的病理生物学变化，其影响并非局部性的。
