Article Figures & Data
Figures
- Fig 1.
Aneurysm permeability modeling in a 14-mm right ICA aneurysm. In the IA, the signal time course from DCE imaging (A) is used to measure the plasma concentration, Cp(t) (red curve, B). The permeability signal, C(t), is subsequently modeled and fit for every voxel to Equation 2. The signal from a single voxel selected from the white circled region adjacent to the IA (white diamonds, B) and fit (yellow curve, B) are shown. The fitting of all voxels derives permeability parameters (Ktrans, VL, and Vp, C). Note the observed signal next to the aneurysm has nearly 3-fold the signal intensity as background (BG) enhancement (blue curve, B). ROIs were placed adjacent to a healthy artery (left panel, D) and the area of highest permeability, next to the IA (right panel, D).
- Fig 2.
Correlation and Bland-Altman analysis between measured Ktrans values of both observers reveal strong agreement in derived values. VL is not shown.
- Fig 3.
DSA and Ktrans permeability images demonstrate a broad distribution of wall permeability values. Notice the heterogeneity in Ktrans both among subjects and within a single IA.
- Fig 4.
The evolution of an untreated posterior communicating artery IA in a 61-year-old man demonstrates that elevated Ktrans at baseline correlated with bleb formation. Morphologic changes during 1.5 years are observed on CTA (A) and DSA (B); however, DCE–MR imaging demonstrates 2 regions with high Ktrans (arrows, C) at the time of imaging—apparently correlating with eventual SAH seen on CT (arrows, D).
- Fig 5.
Mean Ktrans and VL values (black diamonds) increase linearly with larger ISUIA-determined size/risk bins (<7, 7–12, and 13–24 mm) as shown in the scatterplot. Note that our cohort did not contain aneurysms in the >25-mm size/risk bin. The gray circles represent individual IA permeability values. The black diamonds are the mean for each size bin.
Tables
Results of univariate and multivariate logistic regression of demographic and imaging markers against size-independent risk paradigmsa
Group A (High Risk = 7, Low Risk = 17) Group B (High Risk = 15, Low Risk = 9) Group AB (High Risk = 17, Low Risk = 7) P Value Coefficient Standard Error P Value Coefficient Standard Error P Value Coefficient Standard Error Univariate analysis Sex .4092 −0.7985 0.9675 .5231 0.5596 0.8763 .9395 −0.0690 0.9090 Age .4463 −0.0302 0.0396 .1687 0.0563 0.0409 .9774 −0.0011 0.0401 HTNb (n = 19) .9999 27.4910 3.32E + 05 .2560 1.1787 1.0377 .1073 1.7272 1.0724 HLD (n = 17) .3205 1.1856 1.1934 .2115 1.1632 0.9309 .3504 0.8910 0.9541 Statins (n = 12) .4784 0.6444 0.9090 .9158 0.0896 0.8473 .8511 0.1699 0.9052 Tobacco Current use (n = 5) .5526 0.6242 1.0511 .9999 27.93 3.32E + 05 .9999 27.4937 3.32E + 05 Past use (n = 11) .4784 0.6444 0.9090 .9158 0.0896 0.8473 .8511 0.1699 0.9052 Alcoholc (n = 3) .8654 0.2231 1.3166 .2897 −1.3863 1.3093 .1620 −1.1856 1.3276 Imaging markers (n = 24) IA size .0182d 0.2877d 0.1222d .9583 −0.0036 0.0695 .3962 0.0764 0.0900 IA neck .0616 0.5743 0.3072 .6545 −0.1061 0.2370 .5223 0.1880 0.2938 Ktrans .0280d 19.5088d 8.8789d .0243d 23.6481d 10.4975d .0286d 36.5083d 16.6795d Aspect ratio .1074 1.2814 0.7959 .627 0.2073 0.4266 .4511 0.4385 0.5819 VL .2286 4.5210 3.7548 .4176 3.3395 4.1195 .3632 4.4843 4.9321 Multivariate analysis IA Size .0337 0.2448 0.1153 .1534 −0.1591 0.1114 .4435 −0.0817 0.1066 Ktrans .1339 18.5544 12.3781 .0231d 33.9634d 14.9545d .0346d 43.0945d 20.3981d
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