Increased contrast enhancement of the parent vessel of unruptured intracranial aneurysms in 7T MR imaging.

Journal Article (Journal Article)

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.

Full Text

Duke Authors

Cited Authors

  • Samaniego, EA; Roa, JA; Zhang, H; Koscik, TR; Ortega-Gutierrez, S; Bathla, G; Sonka, M; Derdeyn, C; Magnotta, VA; Hasan, D

Published Date

  • October 2020

Published In

Volume / Issue

  • 12 / 10

Start / End Page

  • 1018 - 1022

PubMed ID

  • 32424006

Electronic International Standard Serial Number (EISSN)

  • 1759-8486

Digital Object Identifier (DOI)

  • 10.1136/neurintsurg-2020-015915


  • eng

Conference Location

  • England