Literature DB >> 31261128

Intracranial aneurysm growth: consistency of morphological changes.

Eva L Leemans1,2, Bart M W Cornelissen1,2,3, Miran Said1, René van den Berg2, Cornelis H Slump3, Henk A Marquering1,2, Charles B L M Majoie2.   

Abstract

OBJECTIVE: Previous studies have shown a relation between growth and rupture of intracranial aneurysms. Additionally, several morphological characteristics are frequently measured to estimate rupture risk. Little is known about how the rupture risk is associated with morphological characteristic changes during growth. The aim of this study was to provide insights into how morphological characteristics, associated with rupture, change during an aneurysm's growth.
METHODS: The authors retrospectively identified patients with longitudinal MRA images of unruptured growing aneurysms. The MRA images had an in-plane resolution of 0.2-0.5 mm and a slice thickness of 0.2-0.75 mm. Therefore, growth was defined as an increase of at least 0.5 mm in two directions or 1 mm in one direction. Using the MRA images, the authors semiautomatically segmented the aneurysm and the perianeurysmal vasculature. Twelve morphological characteristics were automatically measured. These characteristics were related to size (diameter, height, width, neck diameter, volume, surface area, aspect ratio, height-width ratio, and bottleneck factor) and shape (ellipticity index, nonsphericity index, and undulation index) of the aneurysm. Morphological characteristics before and after growth were compared using the Wilcoxon signed-rank test.
RESULTS: The authors included 31 patients with 38 growing aneurysms. The aneurysms' growth was detected after a mean of 218 weeks (range 23-567 weeks). A significant increase was seen in all size-related characteristics, and the bottleneck factor also significantly increased (from a median of 1.00 [IQR 0.85-1.04] to 1.03 [IQR 0.93-1.18]), while the ellipticity index decreased (from a median of 0.26 [IQR 0.25-0.28] to 0.25 [IQR 0.24-0.26]). The changes in size ratios and shape indices varied largely among patients. Larger aneurysms more often showed an increase in shape ratios.
CONCLUSIONS: Although aneurysm growth, size-related characteristics, bottleneck factor, and ellipticity index changed significantly during growth, most size ratios and shape indices showed inconsistent changes among aneurysms. This suggests that, for an accurate rupture prediction, morphological parameters need to be reassessed after growth.

Entities:  

Keywords:  AR = aspect ratio; BNF = bottleneck factor; EI = ellipticity index; HWR = height-width ratio; MRA; NSI = nonsphericity index; SAH = subarachnoid hemorrhage; UI = undulation index; aneurysm; growth; morphology; rupture

Year:  2019        PMID: 31261128     DOI: 10.3171/2019.4.FOCUS1987

Source DB:  PubMed          Journal:  Neurosurg Focus        ISSN: 1092-0684            Impact factor:   4.047


  7 in total

1.  Relationship between 3D Morphologic Change and 2D and 3D Growth of Unruptured Intracranial Aneurysms.

Authors:  K M Timmins; H J Kuijf; M D I Vergouwen; Y M Ruigrok; B K Velthuis; I C van der Schaaf
Journal:  AJNR Am J Neuroradiol       Date:  2022-02-10       Impact factor: 3.825

Review 2.  Unruptured cerebral aneurysm risk stratification: Background, current research, and future directions in aneurysm assessment.

Authors:  Michael A Silva; Stephanie Chen; Robert M Starke
Journal:  Surg Neurol Int       Date:  2022-04-29

3.  Bifurcation Configuration Is an Independent Risk Factor for Aneurysm Rupture Irrespective of Location.

Authors:  Qinglin Liu; Peng Jiang; Yuhua Jiang; Shaolin Li; Huijian Ge; Hengwei Jin; Youxiang Li
Journal:  Front Neurol       Date:  2019-08-06       Impact factor: 4.003

4.  Multimodal validation of focal enhancement in intracranial aneurysms as a surrogate marker for aneurysm instability.

Authors:  Naomi Larsen; Charlotte Flüh; Sylvia Saalfeld; Samuel Voß; Georg Hille; David Trick; Fritz Wodarg; Michael Synowitz; Olav Jansen; Philipp Berg
Journal:  Neuroradiology       Date:  2020-07-17       Impact factor: 2.804

5.  Luminal enhancement in intracranial aneurysms: fact or feature?-A quantitative multimodal flow analysis.

Authors:  Franziska Gaidzik; Mariya Pravdivtseva; Naomi Larsen; Olav Jansen; Jan-Bernd Hövener; Philipp Berg
Journal:  Int J Comput Assist Radiol Surg       Date:  2021-09-14       Impact factor: 2.924

6.  A Volumetric Metric for Monitoring Intracranial Aneurysms: Repeatability and Growth Criteria in a Longitudinal MR Imaging Study.

Authors:  X Liu; H Haraldsson; Y Wang; E Kao; M Ballweber; A J Martin; C E McCulloch; F Faraji; D Saloner
Journal:  AJNR Am J Neuroradiol       Date:  2021-06-24       Impact factor: 4.966

7.  Effect of Aneurysm and Patient Characteristics on Intracranial Aneurysm Wall Thickness.

Authors:  Jason M Acosta; Anne F Cayron; Nicolas Dupuy; Graziano Pelli; Bernard Foglia; Julien Haemmerli; Eric Allémann; Philippe Bijlenga; Brenda R Kwak; Sandrine Morel
Journal:  Front Cardiovasc Med       Date:  2021-12-08
  7 in total

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