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European Radiology
Erschienen in:

15.01.2024 | Magnetic Resonance

Wall permeability on magnetic resonance imaging is associated with intracranial aneurysm symptoms and wall enhancement

verfasst von: Qichang Fu, Yi Zhang, Yong Zhang, Chao Liu, Jinyi Li, Meng Wang, Haiyang Luo, Jinxia Zhu, Feifei Qu, Mahmud Mossa-Basha, Sheng Guan, Jingliang Cheng, Chengcheng Zhu

Erschienen in: European Radiology | Ausgabe 8/2024

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Abstract

Objectives

Wall remodeling and inflammation accompany symptomatic unruptured intracranial aneurysms (UIAs). The volume transfer constant (Ktrans) of dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) reflects UIA wall permeability. Aneurysmal wall enhancement (AWE) on vessel wall MRI (VWI) is associated with inflammation. We hypothesized that Ktrans is related to symptomatic UIAs and AWE.

Methods

Consecutive patients with UIAs were prospectively recruited for 3-T DCE-MRI and VWI from January 2018 to March 2023. UIAs were classified as asymptomatic and symptomatic if associated with sentinel headache or oculomotor nerve palsy. Ktrans and AWE were assessed on DCE-MRI and VWI, respectively. AWE was evaluated using the AWE pattern and wall enhancement index (WEI). Spearman’s correlation coefficient and univariate and multivariate analyses were used to assess correlations between parameters.

Results

We enrolled 82 patients with 100 UIAs (28 symptomatic and 72 asymptomatic). The median Ktrans (2.1 versus 0.4 min−1; p < 0.001) and WEI (1.5 versus 0.4; p < 0.001) were higher for symptomatic aneurysms than for asymptomatic aneurysms. Ktrans (odds ratio [OR]: 1.60, 95% confidence interval [95% CI]: 1.01–2.52; p = 0.04) and WEI (OR: 3.31, 95% CI: 1.05–10.42; p = 0.04) were independent risk factors for symptomatic aneurysms. Ktrans was positively correlated with WEI (Spearman’s coefficient of rank correlation (rs) = 0.41, p < 0.001). The combination of Ktrans and WEI achieved an area under the curve of 0.81 for differentiating symptomatic from asymptomatic aneurysms.

Conclusions

Ktrans may be correlated with symptomatic aneurysms and AWE. Ktrans and WEI may provide an additional value than the PHASES score for risk stratification of UIAs.

Clinical relevance statement

The volume transfer constant (Ktrans) from DCE-MRI perfusion is associated with symptomatic aneurysms and provides additional value above the clinical PHASES score for risk stratification of intracranial aneurysms.

Key Points

• The volume transfer constant is correlated with intracranial aneurysm symptoms and aneurysmal wall enhancement.
• Dynamic contrast-enhanced and vessel wall MRI facilitates understanding of the pathophysiological characteristics of intracranial aneurysm walls.
• The volume transfer constant and wall enhancement index perform better than the traditional PHASES score in differentiating symptomatic aneurysms.
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Metadaten
Titel
Wall permeability on magnetic resonance imaging is associated with intracranial aneurysm symptoms and wall enhancement
verfasst von
Qichang Fu
Yi Zhang
Yong Zhang
Chao Liu
Jinyi Li
Meng Wang
Haiyang Luo
Jinxia Zhu
Feifei Qu
Mahmud Mossa-Basha
Sheng Guan
Jingliang Cheng
Chengcheng Zhu
Publikationsdatum
15.01.2024
Verlag
Springer Berlin Heidelberg
Erschienen in
European Radiology / Ausgabe 8/2024
Print ISSN: 0938-7994
Elektronische ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-023-10548-9

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