Vascular Wall Imaging of Unruptured Cerebral Aneurysms with a Hybrid of Opposite-Contrast MR Angiography

Object In this paper, the authors' goals were to clarify the characteristics of growing unruptured cerebral aneurysms detected by serial MR angiography and to establish the recommended follow-up interval. Methods A total of 1002 patients with 1325 unruptured cerebral aneurysms were retrospectively identified. These patients had undergone follow-up evaluation at least twice. Aneurysm growth was defined as an increase in maximum aneurysm diameter by 1.5 times or the appearance of a bleb. Results Aneurysm growth was observed in 18 patients during the period of this study (1.8%/person-year). The annual rupture risk after growth was 18.5%/person-year. The proportion of females among patients with growing aneurysms was significantly larger than those without growing aneurysms (p = 0.0281). The aneurysm wall was reddish, thin, and fragile on intraoperative findings. Frequent follow-up examination is recommended to detect aneurysm growth before rupture. Conclusions Despite the relatively short period, the annual rupture risk of growing unruptured cerebral aneurysms detected by MR angiography was not as low as previously reported. Surgical or endovascular treatment can be considered if aneurysm growth is detected during the follow-up period.

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3D Contrast Enhancement-MR Angiography for Imaging of Unruptured Cerebral Aneurysms: A Hospital-Based Prevalence Study

PLoS ONE ◽

10.1371/journal.pone.0114157 ◽

2014 ◽

Vol 9 (12) ◽

pp. e114157 ◽

Cited By ~ 5

Author(s):

Jing Li ◽

Bixia Shen ◽

Chao Ma ◽

Li Liu ◽

Li Ren ◽

...

Keyword(s):

Contrast Enhancement ◽

Mr Angiography ◽

Cerebral Aneurysms ◽

Prevalence Study ◽

Unruptured Cerebral Aneurysms

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Current uses of intracranial vessel wall imaging for clinical practice: a high-resolution MR technique recently available

Arquivos de Neuro-Psiquiatria ◽

10.1590/0004-282x20200044 ◽

2020 ◽

Vol 78 (10) ◽

pp. 642-650

Author(s):

Felipe Torres PACHECO ◽

Luiz Celso Hygino da CRUZ JUNIOR ◽

Igor Gomes PADILHA ◽

Renato Hoffmann NUNES ◽

Antônio Carlos Martins MAIA JUNIOR ◽

...

Keyword(s):

Clinical Practice ◽

Vessel Wall ◽

Vascular Diseases ◽

Vascular Wall ◽

Vessel Wall Imaging ◽

Clinical Settings ◽

Direct Evaluation ◽

Intracranial Vessel ◽

Indirect Evaluation ◽

Wall Imaging

ABSTRACT Intracranial vessel wall imaging plays an increasing role in diagnosing intracranial vascular diseases. With the growing demand and subsequent increased use of this technique in clinical practice, radiologists and neurologists should be aware of the choices in imaging parameters and how they affect image quality, clinical indications, methods of assessment, and limitations in the interpretation of these images. Due to the improvement of the MRI techniques, the possibility of accurate and direct evaluation of the abnormalities in the arterial vascular wall (vessel wall imaging) has evolved, adding substantial data to diagnosis when compared to the indirect evaluation based on conventional flow analyses. Herein, the authors proposed a comprehensive approach of this technique reinforcing appropriated clinical settings to better use intracranial vessel wall imaging.

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Automated Computerized Method for the Detection of Unruptured Cerebral Aneurysms in DSA Images

Current Medical Imaging Formerly Current Medical Imaging Reviews ◽

10.2174/1573405613666170502162130 ◽

2018 ◽

Vol 14 (5) ◽

pp. 771-777 ◽

Cited By ~ 3

Author(s):

Ines Rahmany ◽

Sabrine Laajili ◽

Nawres Khlifa

Keyword(s):

Cerebral Aneurysms ◽

Computerized Method ◽

Unruptured Cerebral Aneurysms

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Paradoxical Trends in the Management of Unruptured Cerebral Aneurysms in the United States

Stroke ◽

10.1161/strokeaha.110.603803 ◽

2011 ◽

Vol 42 (6) ◽

pp. 1730-1735 ◽

Cited By ~ 56

Author(s):

Michael C. Huang ◽

Ali A. Baaj ◽

Katheryne Downes ◽

A. Samy Youssef ◽

Eric Sauvageau ◽

...

Keyword(s):

United States ◽

Cerebral Aneurysms ◽

The United States ◽

Unruptured Cerebral Aneurysms

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A newly identified hemodynamic parameter to predict the thin-walled regions of unruptured cerebral aneurysms using a computational fluid dynamics analysis

World Neurosurgery ◽

10.1016/j.wneu.2021.05.107 ◽

2021 ◽

Author(s):

Hidehito Kimura ◽

Susumu Osaki ◽

Kosuke Hayashi ◽

Masaaki Taniguchi ◽

Yuichi Fujita ◽

...

Keyword(s):

Fluid Dynamics ◽

Computational Fluid Dynamics ◽

Cerebral Aneurysms ◽

Hemodynamic Parameter ◽

Dynamics Analysis ◽

Computational Fluid Dynamics Analysis ◽

Thin Walled ◽

Unruptured Cerebral Aneurysms

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Abstract 1122‐000145: Impact of Age on Outcomes Following Endovascular vs Clipping of Ruptured and Unruptured Cerebral Aneurysms

Stroke: Vascular and Interventional Neurology ◽

10.1161/svin.01.suppl_1.000145 ◽

2021 ◽

Vol 1 (S1) ◽

Author(s):

Hamidreza Saber ◽

Naoki Kaneko ◽

David Kimball ◽

Jose Morales ◽

Satoshi Tateshima ◽

...

Keyword(s):

Hospital Mortality ◽

Endovascular Therapy ◽

Age Groups ◽

Cerebral Aneurysms ◽

Unruptured Aneurysm ◽

Favorable Outcome ◽

Hospital Length Of Stay ◽

Surgical Clipping ◽

Unruptured Aneurysms ◽

Unruptured Cerebral Aneurysms

Introduction : Age is an important determinant of outcome in patients with unruptured or ruptured cerebral aneurysms. Advancements in endovascular therapies have significantly impacted patient selection and treatment of patients with cerebral aneurysm. Recent release of the National claims data for 2017–2018 provides the opportunity to explore novel population‐level outcomes following clipping vs endovascular treatment of ruptured and unruptured cerebral aneurysms in different age groups. Methods : Analysis of US National Inpatient Sample of hospitalizations with aneurysmal subarachnoid hemorrhage (aSAH) or unruptured aneurysms treated with clipping or endovascular therapy from January 1, 2017 to December 31, 2018. Pre‐defined age strata included: younger than 50 years; 50–64 years; 65–79 years; and 80 years or older. Primary outcomes included in‐hospital mortality and favorable outcome defined as discharge to home. Results : Overall, 34,955 hospitalizations with unruptured aneurysm treatment, (26,695 endovascular and 8,260 surgical clipping), and 17,525 hospitalizations with aSAH were identified in the study period. In unruptured aneurysm group, endovascular therapy was associated with significantly higher favorable outcome across all age groups, and lower mortality in those 65 years or older (all P<0.001) when compared to clipping. Median hospital length‐of‐stay was 1 day (IQR 1–4) in endovascular vs 4 days (IQR 3–8) in clipping group (P<0.001). In aSAH group, endovascular therapy was associated with higher favorable outcome in 50–80 years age groups when compared to clipping, with no significant differences for in‐hospital mortality outcome (Table). Significantly more favorable outcomes were achieved with coiling vs clipping in those aged 65 or above with unruptured aneurysms. Conclusions : In 2017–2018 in US, unruptured aneurysm patients treated with endovascular therapy had significantly lower morbidity and mortality compared to those treated with surgical clipping, and differences were more pronounced with age. Similar but less strong association was observed in patients with aSAH.

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Abstract TP80: Incidence And Risk Factors For The Growth And Rupture Of Unruptured Cerebral Aneurysms. Results Of Annual Radiologic Follow Up Study.

Stroke ◽

10.1161/str.44.suppl_1.atp80 ◽

2013 ◽

Vol 44 (suppl_1) ◽

Author(s):

Katsumi Matsumoto ◽

Kouichirou Tsuruzono ◽

Manabu Sasaki ◽

Noriyasu Yoshimura ◽

Toshiki Yoshimine ◽

...

Keyword(s):

Growth Rate ◽

Cerebral Aneurysms ◽

Aneurysm Rupture ◽

Annual Growth ◽

Annual Growth Rate ◽

Rupture Rate ◽

Follow Up Study ◽

Factors Influencing ◽

Unruptured Cerebral Aneurysms

Background: The recent trend of the treatment of unruptured cerebral aneurysms(UIAs) is going to be conservative. Their natural history of rupture and growth is still unkown. We present the results of annual radiological follow-up study in UIAs. Method: In recent 12 years, we have found 121patients with 148 unruptured cerebral aneurysms were followed annually using 3D-CTA or MRA. Mean follow-up period was 5.5 year. Several factors influencing rupture or growth were statistically examined. Results: Among 121 patients, 9 ruptured and 11 showed growth of UIAs. Annual rupture rate was 1.3% per year and annual growth rate was 1.6% per year. Aneurysm size was the sole factor influencing rupture(P<0.001), whereas female sex and multiplicity were major factors influencing aneurysm growth(P<0.05). Under size 3mm, annual growth rate was 3.0% whereas annual rupture rate was 0.7%. In 4-6mm, growth rate was 1.6% and rupture rate was 1.6%. In 7-9mm, growth rate was 0 and rupture rate was 5.8%. In over 10mm, growth rate was 2.9% and rupture rate was 11.6%. Within 1 year, rupture occurred in 4 cases, and growth was found in 1 case. Conclusions: By annual radiological examination, growth of UIAs was noted more frequently than aneurysm rupture. Especially UIAs under 3mm, growth was 4 times higher than rupture, radiological follow up is effective for aneurysm rupture. Within 1 year, initially found UIAs should be carefully followed in a short interval.

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