PT  - JOURNAL ARTICLE
AU  - Edgar A Samaniego
AU  - Jorge A Roa
AU  - Honghai Zhang
AU  - Timothy R Koscik
AU  - Santiago Ortega-Gutierrez
AU  - Girish Bathla
AU  - Milan Sonka
AU  - Colin Derdeyn
AU  - Vincent A Magnotta
AU  - David Hasan
TI  - Increased contrast enhancement of the parent vessel of unruptured intracranial aneurysms in 7T MR imaging
AID  - 10.1136/neurintsurg-2020-015915
DP  - 2020 Oct 01
TA  - Journal of NeuroInterventional Surgery
PG  - 1018--1022
VI  - 12
IP  - 10
4099  - http://jnis.bmj.com/content/12/10/1018.short
4100  - http://jnis.bmj.com/content/12/10/1018.full
SO  - J NeuroIntervent Surg2020 Oct 01; 12
AB  - Background Inflammation of the 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.Methods Patients with unruptured intracranial aneurysms (UIAs) prospectively 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: circumferential aneurysmal wall enhancement (CAWE); parent vessel enhancement (PVE); and 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 to 0.90).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.