Abstract
Introduction
The aneurysm wall has been reported to play a critical role in the formation, development, and even rupture of an aneurysm. We used high-resolution magnetic resonance imaging (HRMRI) to investigate the aneurysm wall in an effort to identify evidence of inflammation invasion and define its relationship with aneurysm behavior.
Methods
Patients with intracranial aneurysms who were prospectively evaluated using HRMRI between July 2013 and June 2014 were enrolled in this study. The aneurysm’s wall enhancement and evidence of inflammation invasion were determined. In addition, the relationship between aneurysm wall enhancement and aneurysm size and symptoms, including ruptured aneurysms, giant unruputred intracranial aneurysms (UIAs) presenting as mass effect, progressively growing aneurysms, and aneurysms associated with neurological symptoms, was statistically analyzed.
Results
Twenty-five patients with 30 aneurysms were available for the current study. Fourteen aneurysms showed wall enhancement, including 6 ruptured and 8 unruptured aneurysms. Evidence of inflammation was identified directly through histological studies and indirectly through intraoperative investigations and clinical courses. The statistical analysis indicated no significant correlation between aneurysm wall enhancement and aneurysm size. However, there was a strong correlation between wall enhancement and aneurysm symptoms, with a kappa value of 0.86 (95 % CI 0.68–1).
Conclusions
Aneurysm wall enhancement on HRMRI might be a sign of inflammatory change. Symptomatic aneurysms exhibited wall enhancement on HRMRI. Wall enhancement had a high consistent correlation of symptomatic aneurysms. Therefore, wall enhancement on HRMRI might predict an unsteady state of an intracranial saccular aneurysm.
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Acknowledgments
The authors would like to thank Dr Gui-Lin Li for his assistance in this study and preparation of this manuscript. PH and H-QZ are financially supported by Capital Development Funds of Medical Science (Grant number 2011-1001-01). PH is sponsored by the National Natural Science Foundation (Grant number of 81500988).
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We declare that all human and animal studies have been approved by the ethics committee of Xuanwu Hospital, Capital Medical University, and have therefore been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments. We declare that all patients gave informed consent prior to inclusion in this study.
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Hu, P., Yang, Q., Wang, DD. et al. Wall enhancement on high-resolution magnetic resonance imaging may predict an unsteady state of an intracranial saccular aneurysm. Neuroradiology 58, 979–985 (2016). https://doi.org/10.1007/s00234-016-1729-3
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DOI: https://doi.org/10.1007/s00234-016-1729-3