Abstract

BACKGROUND

High-resolution vessel wall imaging plays an increasingly important role in assessing the risk of aneurysm rupture.

OBJECTIVE

To introduce an approach toward the validation of the wall enhancement as a direct surrogate parameter for aneurysm stability.

METHODS

A total of 19 patients harboring 22 incidental intracranial aneurysms were enrolled in this study. The aneurysms were dichotomized according to their aneurysm-to-pituitary stalk contrast ratio using a cutoff value of 0.5 (nonenhancing < 0.5; enhancing ≥ 0.5). We evaluated the association of aneurysm wall enhancement with morphological characteristics, hemodynamic features, and inflammatory chemokines directly measured inside the aneurysm.

RESULTS

Differences in plasma concentration of chemokines and inflammatory molecules, morphological, and hemodynamic parameters were analyzed using the Welch test or Mann-Whitney U test. The concentration ΔIL-10 in the lumen of intracranial aneurysms with low wall enhancement was significantly increased compared to aneurysms with strong aneurysm wall enhancement (P = .014). The analysis of morphological and hemodynamic parameters showed significantly increased values for aneurysm volume (P = .03), aneurysm area (P = .044), maximal diameter (P = .049), and nonsphericity index (P = .021) for intracranial aneurysms with strong aneurysm wall enhancement. None of the hemodynamic parameters reached statistical significance; however, the total viscous shear force computed over the region of low wall shear stress showed a strong tendency toward significance (P = .053).

CONCLUSION

Aneurysmal wall enhancement shows strong associations with decreased intrasaccular IL-10 and established morphological indicators of aneurysm instability.

中文翻译：

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动脉瘤壁增强与囊内 IL-10 减少和不稳定的形态特征相关

 抽象的

 背景

高分辨率血管壁成像在评估动脉瘤破裂风险方面发挥着越来越重要的作用。

 客观的

介绍一种验证壁增强作为动脉瘤稳定性直接替代参数的方法。

 方法

本研究共有 19 名患有 22 个偶然颅内动脉瘤的患者入组。根据动脉瘤与垂体柄的对比度，使用 0.5 的截止值（非增强 < 0.5；增强 ≥ 0.5）将动脉瘤分为两类。我们评估了动脉瘤壁强化与动脉瘤内部直接测量的形态特征、血流动力学特征和炎症趋化因子的关联。

 结果

使用Welch检验或Mann-Whitney U检验分析趋化因子和炎症分子的血浆浓度、形态学和血流动力学参数的差异。与具有强动脉瘤壁增强的动脉瘤相比，具有低壁增强的颅内动脉瘤的管腔中的ΔIL-10浓度显着增加（ P = .014）。形态和血流动力学参数分析显示，颅内动脉瘤体积 ( P = .03)、动脉瘤面积 ( P = .044)、最大直径 ( P = .049) 和非球形指数 ( P = .021) 显着增加。动脉瘤具有强烈的动脉瘤壁强化。血流动力学参数均未达到统计学意义；然而，在低壁剪切应力区域计算的总粘性剪切力显示出强烈的显着趋势 ( P = .053)。

 结论

动脉瘤壁增强显示与囊内 IL-10 减少和已确定的动脉瘤不稳定性形态学指标密切相关。