Objective To identify the morphological parameters correlated with the rupture of middle cerebral artery (MCA) aneurysms.
Methods We retrospectively analyzed the digital subtraction angiography (DSA) data of 48 patients with ruptured mirror MCA aneurysms. Morphological parameters included aneurysm with wall protrusion, maximum diameter (Dmax), height, neck width, aneurysm width, dome projection, parent artery average diameter (Dp), aspect ratio (AR), bottleneck factor (BNF), size ratio (SR), M1/M2 ratio, and height/width (H/W) ratio. These paired parameters were analyzed by conditional univariate and multivariate logistic regressions to screen out the independent risk factors. We established a score based on the independent risk factors. Receiver operating characteristics (ROC) were generated to estimate the prediction performance of the score in our large database of 763 aneurysms.
Results In the univariate regressions, Dmax, height, aneurysm width, neck width, AR, BNF, H/W ratio, SR, anterior dome projection and aneurysm with wall protrusion were significant risk factors. Aneurysm width (OR 3.296, p=0.015), AR (OR 11.594, p=0.014) and anterior dome projection (OR 9.385, p=0.016) were independent risk factors in multivariate regression. The area under the curve (AUC) value of the score based on the three independent risk factors was 0.829.
Conclusion Aneurysm width, AR and anterior dome projection were independent risks factors of rupture.
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Contributors WX designed the data collection tools, collected the data for the whole study, wrote the statistical analysis plan, cleaned and analyzed the data, and drafted and revised the paper. He is the guarantor. HW analyzed the data, and drafted and revised the paper. QW, LW, ZYou, HW, BY, SC and XZ revised the draft paper.
Funding This work was supported by Jiangsu Provincial Talent (grant No. ZDRCA2016094) and Natural Science Foundation of Jiangsu Province (grant No. BK20181240).
Competing interests None declared.
Patient consent for publication Not required.
Provenance and peer review Not commissioned; externally peer reviewed.
Data availability statement All data relevant to the study are included in the article or uploaded as supplementary information. Our data are available from our institute’s database.