Article Text

PDF
Original research
Assessment of intracranial aneurysm rupture based on morphology parameters and anatomical locations
  1. Yongtao Zheng1,
  2. Feng Xu1,
  3. Jinma Ren2,
  4. Qiang Xu3,
  5. Yingjun Liu1,
  6. Yanlong Tian1,
  7. Bing Leng1
  1. 1Department of Neurosurgery, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, China
  2. 2Center for Health Outcomes Research, University of Illinois College of Medicine at Peoria, Peoria, Illinois, USA
  3. 3Department of Radiology, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, China
  1. Correspondence to Professor Bing Leng, Department of Neurosurgery, Huashan Hospital, Shanghai Medical College, Fudan University, No 12 Wulumuqi Middle Road, Shanghai 200040, China; lengbing12345678{at}126.com

Abstract

Objectives The aim of the present study was to identify image-based morphological parameters and anatomical locations associated with intracranial aneurysm (IA) rupture.

Methods Nine morphological parameters and aneurysm location were evaluated in 150 patients with saccular IAs (82 unruptured, 68 ruptured) using three-dimensional geometry. Aneurysm location and morphological parameters including size, aspect ratio, size ratio, height–width ratio, flow angle, aneurysm inclination angle, parent artery angle, vessel angle, and aneurysm shape were explored to identify a correlation with aneurysm rupture. These factors were analyzed using a two-tailed independent Student t test or the χ test for significance. Significant factors were further examined using logistic regression analysis. Additionally, receiver operating characteristic (ROC) analysis was performed to evaluate each parameter.

Results Statistically significant differences were observed in ruptured and unruptured groups for aspect ratio, size ratio, height–width ratio, flow angle, aneurysm inclination angle, vessel angle, aneurysm shape, and aneurysm location. Logistic regression analysis further revealed that size ratio (OR 1.66; 95% CI 1.05 to 2.64), height–width ratio (OR 14.22; 95% CI 2.67 to 75.88), aneurysm inclination angle (OR 1.04; 95% CI 1.01 to 1.07), aneurysm shape (OR 4.68; 95% CI 2.44 to 8.98), and aneurysm location (OR 1.60; 95% CI 1.15 to 2.23) had the strongest independent correlation with ruptured IA. The ROC analysis showed that the size ratio and flow angle had the highest area under the curve, with values of 0.735 and 0.730, respectively.

Conclusions Size ratio, height–width ratio, aneurysm inclination angle, aneurysm shape, and aneurysm location might be important for discriminating between ruptured and unruptured aneurysms. Further investigation will determine whether these morphological parameters and anatomical locations will be reliable predictors of aneurysm rupture.

  • Aneurysm

Statistics from Altmetric.com

Footnotes

  • YZ and FX contributed equally.

  • Contributors BL and YZ: Conception and design. YZ, JR, QX, YT, and YL: Analysis and interpretation of the data. YZ and FX: Drafting the article. All authors critically revised the article, reviewed the final version of the manuscript and approved it for submission.

  • Competing interests None declared.

  • Ethics approval Huashan Hospital, Fudan University.

  • Provenance and peer review Not commissioned; externally peer reviewed.

Request permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.