Department of Neurosurgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan.
Department of Neurosurgery, Itsukaichi Memorial Hospital, Hiroshima, Japan.
World Neurosurg. 2022 Nov;167:e122-e126. doi: 10.1016/j.wneu.2022.07.119. Epub 2022 Aug 7.
Inflammatory atherosclerotic remodeling of unruptured intracranial aneurysms (UIAs) wall, which could be detected as aneurysm wall enhancement (AWE) in MR vessel wall imaging (VWI), plays a pivotal role in pathophysiology of progression to rupture. On the other hand, abdominal aortic calcification reflects the extent of systemic atherosclerosis, which in turn predicts the risk of atherosclerotic cardiovascular as well as cerebrovascular diseases. This study sought to investigate whether the abdominal aortic calcification was associated with increased wall enhancement of UIAs in VWI.
This retrospective study reviewed subjects who underwent evaluation using 3T MR-VWI of UIAs and abdominal CT before endovascular treatments for UIAs between 2018 to 2020. Abdominal aortic calcification volume (ACV) was quantitatively measured from abdominal CT scans between renal arteries and bifurcation. The presence of AWE was correlated with patient profile, aneurysm morphology, and the ACV.
A total of 42 patients with 50 UIAs were included. AWE was detected in 19 (38.0%) UIAs. Maximum diameter (9.2 ± 5.0 mm vs 5.3 ± 1.5 mm, P < 0.01) and the ACV (8.2 ± 6.0 mL vs 4.7 ± 4.6 mL, P = 0.038) were significantly higher in UIAs with AWE than those without AWE.
The ACV was significantly associated with increased wall enhancement of UIAs. Systemic atherosclerosis might be a risk factor for the instability of UIAs. Future studies examining the effect of medications for systemic atherosclerosis on the extent of AWE in UIAs is warranted.
未破裂颅内动脉瘤（UIAs）壁的炎症性动脉粥样硬化性重塑，在磁共振血管壁成像（VWI）中可检测到动脉瘤壁增强（AWE），在进展为破裂的病理生理学中起着关键作用。另一方面，腹主动脉钙化反映了全身动脉粥样硬化的程度，进而预测了动脉粥样硬化性心血管和脑血管疾病的风险。本研究旨在探讨腹主动脉钙化与 VWI 中 UIAs 壁增强的关系。
本回顾性研究纳入了 2018 年至 2020 年期间因 UIAs 行血管内治疗而行 3T MR-VWI 和腹部 CT 检查的患者。从肾动脉至分叉处的腹部 CT 扫描中定量测量腹主动脉钙化体积（ACV）。将 AWE 的存在与患者特征、动脉瘤形态和 ACV 相关联。
共纳入 42 例患者的 50 个 UIAs。19 个（38.0%）UIAs 检测到 AWE。与无 AWE 的 UIAs 相比，有 AWE 的 UIAs 的最大直径（9.2 ± 5.0 mm 比 5.3 ± 1.5 mm，P < 0.01）和 ACV（8.2 ± 6.0 mL 比 4.7 ± 4.6 mL，P = 0.038）明显更高。
ACV 与 UIAs 壁增强显著相关。全身动脉粥样硬化可能是 UIAs 不稳定的危险因素。未来需要研究检查用于全身动脉粥样硬化的药物对 UIAs 中 AWE 程度的影响。
