Introduction Identifying the symptomatic aneurysm in patients with multiple intracranial aneurysms (MIAs) can be challenging. Aneurysm wall enhancement (AWE) is a potential tool for assessing intracranial aneurysms (IAs).¹ Radiomic features (RFs) offers detailed voxel-imaging analysis.² AWE and RFs can offer a novel approach in the assessment of symptomatic aneurysms in patients with MIAs.

Aim of Study Analyze AWE and RFs of symptomatic aneurysms in patients with MIAs.

Methods Patients with MIAs underwent high resolution 3T MRI. Manual segmentations of the aneurysm wall were created using 3D Slicer. RFs were extracted using an add-in. A previously described pipeline was employed to quantify the signal intensity (SI) of the aneurysm wall.³ The mean SI after gadolinium administration was computed and defined as three dimensional-circumferential AWE (3D-CAWE). Aneurysms with a 3D-CAWE higher than the mean SI of the corpus callosum post gadolinium were classified as positive. Student’s t test and logistic regression were conducted for the statistical analysis.

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Abstract P083 Figure 1

Pipeline of AWE extraction. A) 3T MRI showing aneurysms in the left and right internal carotid artery. B) 3D Slicer segmentation. C) AWE heat-map generated

Results Twenty patients with MIAs and a total of 47 saccular aneurysms were included. 7 aneurysms were symptomatic and 40 were asymptomatic. 130 RFs were extracted. 3D-CAWE was different between symptomatic and asymptomatic aneurysms (p< 0.05). 3D-CAWE positive IAs were more likely to be symptomatic (OR= 23.75, p=0.04). Three RFs were different (p<0.05) between symptomatic and asymptomatic IAs.

Conclusion 3D-CAWE and radiomics analysis could help identify the symptomatic aneurysm in patients with MIAs.