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Gadolinium-enhanced intracranial aneurysm wall imaging and risk of aneurysm growth and rupture: a multicentre longitudinal cohort study

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机构： [1]Department of Neurology and Neurosurgery, UMC Utrecht Brain Center, Utrecht University, University Medical Center Utrecht, room number G3‑201, Postbox 85500, 3508 Utrecht, GA, The Netherlands [2]Department of Radiology, APHP, Hôpitaux Raymond‑Poincaré and Ambroise Paré, DMU Smart Imaging, Laboratoire d’imagerie Biomédicale Multimodale (BioMaps), GH Université Paris-Saclay, Université Paris-Saclay, CEA, CNRS, Inserm, Service Hospitalier Fré‑déric Joliot, Orsay, France [3]Department of Neuroradiology, Université de Paris, IMABRAIN-INSERM-UMR1266, DHU-Neurovasc, GHU Paris, Centre Hospitalier Sainte-Anne, Paris, France [4]Department of Neurosurgery and Interventional Neuroradiology, Hiroshima City Asa Citizens Hospital, Hiroshima, Japan [5]Department of Neurosurgery, University Hospital Southampton, University Hospital Southampton NHS Foundation Trust, Southampton, UK [6]Department of Radiology, University of Washington School of Medicine, Seattle, WA, USA [7]Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, CA, USA [8]Department of Neurosurgery, Capital Medical University Xuanwu Hospital, Capital Medical University, Bejing, China [9]Department of Radiology, University of North Carolina, Chapel Hill, NC, USA [10]Department of Radiology, Changhai Hospital, Shanghai, China [11]Department of Neurosurgery and Interventional Neuroradiology, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan [12]Department of Magnetic Resonance, The First Afliated Hospital of Zhengzhou University, Zhengzhou, China [13]Department of Radiology, Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China [14]Department of Biomedical Engineering, School of Medicine, Tsinghua University, Bejing, China [15]Department of Radiology, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands

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关键词： Brain Intracranial aneurysm Magnetic resonance imaging Risk factors

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In patients with an unruptured intracranial aneurysm, gadolinium enhancement of the aneurysm wall is associated with growth and rupture. However, most previous studies did not have a longitudinal design and did not adjust for aneurysm size, which is the main predictor of aneurysm instability and the most important determinant of wall enhancement. We investigated whether aneurysm wall enhancement predicts aneurysm growth and rupture during follow-up and whether the predictive value was independent of aneurysm size.In this multicentre longitudinal cohort study, individual patient data were obtained from twelve international cohorts. Inclusion criteria were as follows: 18 years or older with ≥ 1 untreated unruptured intracranial aneurysm < 15 mm; gadolinium-enhanced aneurysm wall imaging and MRA at baseline; and MRA or rupture during follow-up. Patients were included between November 2012 and November 2019. We calculated crude hazard ratios with 95%CI of aneurysm wall enhancement for growth (≥ 1 mm increase) or rupture and adjusted for aneurysm size.In 455 patients (mean age (SD), 60 (13) years; 323 (71%) women) with 559 aneurysms, growth or rupture occurred in 13/194 (6.7%) aneurysms with wall enhancement and in 9/365 (2.5%) aneurysms without enhancement (crude hazard ratio 3.1 [95%CI: 1.3-7.4], adjusted hazard ratio 1.4 [95%CI: 0.5-3.7]) with a median follow-up duration of 1.2 years.Gadolinium enhancement of the aneurysm wall predicts aneurysm growth or rupture during short-term follow-up, but not independent of aneurysm size.Gadolinium-enhanced aneurysm wall imaging is not recommended for short-term prediction of growth and rupture, since it appears to have no additional value to conventional predictors.• Although aneurysm wall enhancement is associated with aneurysm instability in cross-sectional studies, it remains unknown whether it predicts risk of aneurysm growth or rupture in longitudinal studies. • Gadolinium enhancement of the aneurysm wall predicts aneurysm growth or rupture during short-term follow-up, but not when adjusting for aneurysm size. • While gadolinium-enhanced aneurysm wall imaging is not recommended for short-term prediction of growth and rupture, it may hold potential for aneurysms smaller than 7 mm.© 2023. The Author(s).

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出版当年[2023]版：

大类 | 2 区

医学

小类 | 2 区核医学

最新[2023]版：

大类 | 2 区

医学

小类 | 2 区核医学

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出版当年[2022]版：

Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

最新[2023]版：

Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

影响因子： 4.7 最新[2023版] 5.2 最新五年平均 5.9 出版当年[2022版] 5.5 出版当年五年平均 7.034 出版前一年[2021版] 4.7 出版后一年[2023版]

第一作者：

第一作者机构： [1]Department of Neurology and Neurosurgery, UMC Utrecht Brain Center, Utrecht University, University Medical Center Utrecht, room number G3‑201, Postbox 85500, 3508 Utrecht, GA, The Netherlands

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Gadolinium-enhanced intracranial aneurysm wall imaging and risk of aneurysm growth and rupture: a multicentre longitudinal cohort study

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