Jian Zhang1,2, Anil Can1, Srinivasan Mukundan3, Michael Steigner3, Victor M Castro4, Dmitriy Dligach5, Sean Finan6, Sheng Yu7, Vivian Gainer4, Nancy A Shadick8, Guergana Savova6, Shawn Murphy4,9, Tianxi Cai10, Zhong Wang2, Scott T Weiss11, Rose Du1,11. 1. Department of Neurosurgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts. 2. Department of Neurosurgery & Brain and Nerve Research Laboratory, The First Affiliated Hospital of Soochow University, Jiangsu Province, China. 3. Department of Radiology, Brigham and Women's Hospital, Boston, Massachusetts. 4. Research Information Systems and Computing, Partners Healthcare, Boston, Massachusetts. 5. Department of Computer Science, Loyola University, Chicago, Illinois. 6. Boston Children's Hospital Informatics Program, Boston, Massachusetts. 7. Center for Statistical Science, Tsinghua University, Beijing, China. 8. Division of Rheumatology, Immunology and Allergy, Brigham and Women's Hospital, Boston, Massachusetts. 9. Department of Neurology, Massachusetts General Hospital, Boston, Massachusetts. 10. Biostatistics, Harvard School of Public Health, Boston, Massachusetts. 11. Channing Division of Network Medicine, Brigham and Women's Hospital, Boston, Massachusetts.
Abstract
BACKGROUND: Geometric factors of intracranial aneurysms and surrounding vasculature could affect the risk of aneurysm rupture. However, large-scale assessments of morphological parameters correlated with intracranial aneurysm rupture in a location-specific manner are scarce. OBJECTIVE: To investigate the morphological characteristics associated with ruptured middle cerebral artery (MCA) aneurysms. METHODS: Five hundred sixty-one patients with 638 MCA aneurysms diagnosed between 1990 and 2016 who had available computed tomography angiography (CTA) were included in this study. CTAs were evaluated using the Vitrea Advanced Visualization software for 3-dimensional (3D) reconstruction. Morphological parameters examined in each model included aneurysm projection, wall irregularity, presence of a daughter dome, presence of hypoplastic or aplastic A1 arteries and hypoplastic or fetal posterior communicating arteries (PCoA), aneurysm height and width, neck diameter, bottleneck factor, aspect and size ratio, height/width ratio, and diameters and angles of surrounding parent and daughter vessels. Univariable and multivariable statistical analyses were performed to determine the association of morphological characteristics with rupture of MCA aneurysms. Logistic regression was used to build a predictive MCA score. RESULTS: Greater bottleneck and size ratio, and irregular, multilobed, temporally projecting MCA aneurysms are associated with higher rupture risk, whereas higher M1/M2 ratio, larger width, and the presence of an ipsilateral or bilateral hypoplastic PCoA were inversely associated with rupture. The MCA score had good predictive capacity with area under the receiver operating curve = 0.88. CONCLUSION: These practical morphological parameters specific to MCA aneurysms are easy to assess when examining 3D reconstructions of unruptured aneurysms and could aid in risk evaluation in these patients.
BACKGROUND: Geometric factors of intracranial aneurysms and surrounding vasculature could affect the risk of aneurysm rupture. However, large-scale assessments of morphological parameters correlated with intracranial aneurysm rupture in a location-specific manner are scarce. OBJECTIVE: To investigate the morphological characteristics associated with ruptured middle cerebral artery (MCA) aneurysms. METHODS: Five hundred sixty-one patients with 638 MCA aneurysms diagnosed between 1990 and 2016 who had available computed tomography angiography (CTA) were included in this study. CTAs were evaluated using the Vitrea Advanced Visualization software for 3-dimensional (3D) reconstruction. Morphological parameters examined in each model included aneurysm projection, wall irregularity, presence of a daughter dome, presence of hypoplastic or aplastic A1 arteries and hypoplastic or fetal posterior communicating arteries (PCoA), aneurysm height and width, neck diameter, bottleneck factor, aspect and size ratio, height/width ratio, and diameters and angles of surrounding parent and daughter vessels. Univariable and multivariable statistical analyses were performed to determine the association of morphological characteristics with rupture of MCA aneurysms. Logistic regression was used to build a predictive MCA score. RESULTS: Greater bottleneck and size ratio, and irregular, multilobed, temporally projecting MCA aneurysms are associated with higher rupture risk, whereas higher M1/M2 ratio, larger width, and the presence of an ipsilateral or bilateral hypoplastic PCoA were inversely associated with rupture. The MCA score had good predictive capacity with area under the receiver operating curve = 0.88. CONCLUSION: These practical morphological parameters specific to MCA aneurysms are easy to assess when examining 3D reconstructions of unruptured aneurysms and could aid in risk evaluation in these patients.
Authors: Jian Zhang; Anil Can; Pui Man Rosalind Lai; Srinivasan Mukundan; Victor M Castro; Dmitriy Dligach; Sean Finan; Sheng Yu; Vivian S Gainer; Nancy A Shadick; Guergana Savova; Shawn N Murphy; Tianxi Cai; Scott T Weiss; Rose Du Journal: Sci Rep Date: 2020-07-14 Impact factor: 4.379
Authors: Anil Can; Pui Man Rosalind Lai; Victor M Castro; Sheng Yu; Dmitriy Dligach; Sean Finan; Vivian Gainer; Nancy A Shadick; Guergana Savova; Shawn Murphy; Tianxi Cai; Scott T Weiss; Rose Du Journal: Sci Rep Date: 2019-04-15 Impact factor: 4.379
Authors: Jian Zhang; Anil Can; Pui Man Rosalind Lai; Srinivasan Mukundan; Victor M Castro; Dmitriy Dligach; Sean Finan; Vivian S Gainer; Nancy A Shadick; Guergana Savova; Shawn N Murphy; Tianxi Cai; Scott T Weiss; Rose Du Journal: Sci Rep Date: 2021-01-28 Impact factor: 4.379
Authors: Jian Zhang; Pui Man Rosalind Lai; Anil Can; Srinivasan Mukundan; Victor M Castro; Dmitriy Dligach; Sean Finan; Vivian S Gainer; Nancy A Shadick; Guergana Savova; Shawn N Murphy; Tianxi Cai; Scott T Weiss; Rose Du Journal: Sci Rep Date: 2021-02-26 Impact factor: 4.379