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© Research
Publication : Stroke; a journal of cerebral circulation

Does aneurysmal wall enhancement on vessel wall MRI help to distinguish stable from unstable intracranial aneurysms?

Scientific Fields
Diseases
Organisms
Applications
Technique

Published in Stroke; a journal of cerebral circulation - 16 Oct 2014

Edjlali M, Gentric JC, Régent-Rodriguez C, Trystram D, Hassen WB, Lion S, Nataf F, Raymond J, Wieben O, Turski P, Meder JF, Oppenheim C, Naggara O

Link to Pubmed [PMID] – 25325912

Stroke 2014 Dec;45(12):3704-6

BACKGROUND AND PURPOSE: Arterial wall enhancement on vessel wall MRI was described in intracranial inflammatory arterial disease. We hypothesized that circumferential aneurysmal wall enhancement (CAWE) could be an indirect marker of aneurysmal wall inflammation and, therefore, would be more frequent in unstable (ruptured, symptomatic, or undergoing morphological modification) than in stable (incidental and nonevolving) intracranial aneurysms.

METHODS: We prospectively performed vessel wall MRI in patients with stable or unstable intracranial aneurysms. Two readers independently had to determine whether a CAWE was present.

RESULTS: We included 87 patients harboring 108 aneurysms. Interreader and intrareader agreement for CAWE was excellent (κ=0.85; 95% confidence interval, 0.75-0.95 and κ=0.90; 95% confidence interval, 0.83-0.98, respectively). A CAWE was significantly more frequently seen in unstable than in stable aneurysms (27/31, 87% versus 22/77, 28.5%, respectively; P<0.0001). Multivariate logistic regression, including CAWE, size, location, multiplicity of aneurysms, and daily aspirin intake, revealed that CAWE was the only independent factor associated with unstable status (odds ratio, 9.20; 95% confidence interval, 2.92-29.0; P=0.0002).

CONCLUSIONS: CAWE was more frequently observed in unstable intracranial aneurysms and may be used as a surrogate of inflammatory activity in the aneurysmal wall.