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Oral Abstracts
O-021 Increased contrast enhancement of the parent vessel of unruptured intracranial aneurysms in 7T MR imaging
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  1. E Samaniego1,
  2. J Roa2,
  3. H Zhang3,
  4. T Koscik4,
  5. S Ortega-Gutierrez1,
  6. G Bathla5,
  7. M Sonka3,
  8. C Derdeyn5,
  9. V Magnotta5,
  10. D Hasan6
  1. 1Neurology, Neurosurgery and Radiology, University of Iowa Hospitals and Clinics, Iowa City, IA
  2. 2Neurology and Neurosurgery, University of Iowa Hospitals and Clinics, Iowa City, IA
  3. 3Electrical and Computer Engineering, Iowa Institute of Biomedical Imaging, University of Iowa Hospitals and Clinics, Iowa City, IA
  4. 4Psychiatry, University of Iowa Hospitals and Clinics, Iowa City, IA
  5. 5Radiology, University of Iowa Hospitals and Clinics, Iowa City, IA
  6. 6Neurosurgery, University of Iowa Hospitals and Clinics, Iowa City, IA

Abstract

Background Inflammation of the cerebral arterial wall may lead to aneurysm formation. The presence of aneurysm enhancement on high-resolution vessel wall imaging (HR-VWI) is a marker of wall inflammation and instability. We aim to determine if there is any association between increased contrast enhancement in the aneurysmal wall and its parent artery using 7T HR-VWI.

Methods Patients with unruptured intracranial aneurysms (UIAs) underwent 7T HR-VWI. Regions of interest were selected manually and with a semi-automated protocol based on gradient algorithms of intensity patterns. Mean signal intensities in pre- and post-contrast T1-weighted sequences were adjusted to the enhancement of the pituitary stalk and then subtracted to objectively determine: 1) circumferential aneurysmal wall enhancement (CAWE), 2) parent vessel enhancement (PVE), and 3) reference vessel enhancement (RVE). PVE was assessed over regions located 3- and 5-mm from the aneurysm’s neck. RVE was assessed in arteries located in a different vascular territory.

Results Twenty-five UIAs were analyzed. There was a significant moderate correlation between CAWE and 5-mm PVE (Pearson R=0.52, P=0.008), whereas no correlation was found between CAWE and RVE (Pearson R=0.20, P=0.33). A stronger correlation was found between CAWE and 3-mm PVE (Pearson R=0.78, P<0.001). Intra-class correlation analysis demonstrated good reliability between measurements obtained using semi-automated and manual segmentation (ICC coefficient = 0.790, 95% CI 0.58 – 0.90).

Abstract O-021 Figure 1
Abstract O-021 Figure 1
Abstract O-021 Figure 2
Abstract O-021 Figure 2

Conclusion Parent arteries exhibit higher contrast enhancement in regions closer to the aneurysm’s neck, especially in aneurysms ≥ 7 mm. A localized inflammatory/vasculopathic process in the wall of the parent artery may lead to aneurysm formation and growth.

Disclosures E. Samaniego: 1; C; SVIN 2019, Bee Foundation 2019. 2; C; Medtronic, MicroVention. J. Roa: None. H. Zhang: None. T. Koscik: None. S. Ortega-Gutierrez: 2; C; Stryker, MicroVention. G. Bathla: None. M. Sonka: None. C. Derdeyn: None. V. Magnotta: None. D. Hasan: None.

https://doi.org/10.1136/neurintsurg-2020-SNIS.21

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