Article Figures & Data
Figures
- Fig 1.
Measuring aneurysm wall permeability by DCE-MR imaging. Signal intensity in the lumen was measured on DCE imaging series (red contour in A) to obtain contrast concentration in plasma at different time points, which gave the arterial input function Cp(t) (red curve in C). The concentration-time curve of tissue C(t) was fitted voxel by voxel using the extended Kety/Tofts model, which generated parametric maps that were overlaid onto DCE images (B). ROIs were placed on the slice with highest Ktrans to measure Ktrans in the region adjacent to intracranial aneurysms (IA-ROI, white contour on Ktrans map in B) and near a normal artery. The concentration-time curves of points 1 and 2 (red dots in B) are shown in D. ref-ROI indicates reference ROI.
- Fig 2.
Enhanced aneurysm wall with and without increased permeability. Case 1: A 51-year-old woman who presented with a 19.5-mm aneurysm in the internal carotid artery. Pre- and postcontrast vessel wall images show conspicuous wall enhancement. DCE-MR imaging shows increased wall permeability (Ktrans = 0.0346 min−1). Case 2: A 61-year-old woman who presented with a 9-mm aneurysm in the anterior communicating artery. Pre- and postcontrast vessel wall imaging shows conspicuous wall enhancement, but DCE-MR imaging did not show increased wall permeability (Ktrans = 0.0096 min−1).
- Fig 3.
Associations between aneurysm wall permeability and size (A) and the PHASES score (B). Spearman correlation analysis shows that Ktrans is positively correlated with aneurysm size (ρ = 0.54, P = .002) and the PHASES score (ρ = 0.40, P = .030).
- Fig 4.
Association between Ktrans and aneurysm wall enhancement. Ktrans shows no statistically significant association with the presence of aneurysm wall enhancement (A) and a poor concordance with the wall enhancement index (B).
- Fig 5.
Baseline MR images of the 2 aneurysms that ruptured during follow-up. Case 1: A 36-year-old man has a 17.1-mm aneurysm in the basilar artery. The patient was concerned about surgical risk and received conservative treatment. Subarachnoid hemorrhage occurred 5 months after the baseline scan (no aneurysm wall enhancement; Ktrans = 0.0449 min−1). Case 2: A 68-year-old man had an 8.5-mm aneurysm in the basilar artery. The patient was concerned about surgical risk and received conservative treatment. Subarachnoid hemorrhage occurred 1 month after baseline scan (no aneurysm wall enhancement; Ktrans = 0.0524 min−1).
Tables
PHASES Aneurysm Risk Score Points (P) Population North American, European (other than Finnish) 0 Japanese 3 Finnish 5 (H) Hypertension No 0 Yes 1 (A) Age Younger than 70 yr 0 70 yr or older 1 (S) Size of aneurysm <7.0 mm 0 7.0–9.9 mm 3 10.0–19.9 mm 6 ≥20.0 mm 10 (E) Earlier SAH from another aneurysm No 0 Yes 1 (S) Site of aneurysm ICA 0 MCA 2 ACA/PcomA/posterior circulation 4 Note:—ACA indicates anterior cerebral arteries (including the anterior cerebral artery, anterior communicating artery, and pericallosal artery); ICA, internal carotid artery; MCA, middle cerebral artery; PcomA, posterior communicating artery; SAH, subarachnoid hemorrhage.
No. (%), Mean, or Median (IQR) Age (yr) 53.9 ± 13.5 Male sex 7 (24%) Current smoking 5 (17%) Hypertension 11 (38%) Diabetes 2 (7%) Location Anterior circulation 18 (62%) Posterior circulation 11 (38%) Size <7.0 mm 7 (24%) 7.0–9.9 mm 8 (28%) 10.0–19.9 mm 7 (24%) ≥20.0 mm 7 (24%) Blebs 3 (10%) PHASES score 8 (4.75–10) Ktrans (min−1) 0.0107 (0.0060–0.0390) Aneurysm wall enhancement 19 (66%) ↵a See Table 1 for details of the PHASES score.
Jump to section
Related Articles
Cited By...
- A Review of Intracranial Aneurysm Imaging Modalities, from CT to State-of-the-Art MR
- 3D aneurysm wall enhancement is associated with symptomatic presentation
- Quantitative analysis of unruptured intracranial aneurysm wall thickness and enhancement using 7T high resolution, black blood magnetic resonance imaging
- Atorvastatin for unruptured intracranial vertebrobasilar dissecting aneurysm (ATREAT-VBD): protocol for a randomised, double-blind, blank-controlled trial
- In situ decellularization of a large animal saccular aneurysm model: sustained inflammation and active aneurysm wall remodeling