scholarly journals Vessel Wall Imaging of Unruptured Intracranial Aneurysms: Ready for Prime Time? Not so Fast!

2019 ◽  
Vol 40 (6) ◽  
pp. E26-E29 ◽  
Author(s):  
V.T. Lehman ◽  
W. Brinjikji
Keyword(s):  
Vessel Wall ◽  
Intracranial Aneurysms ◽  
Vessel Wall Imaging ◽  
Prime Time ◽  
Unruptured Intracranial Aneurysms ◽  
Wall Imaging

Vessel Wall Imaging Predicts the Presence of Atherosclerotic Lesions in Unruptured Intracranial Aneurysms

2019 ◽  
Vol 132 ◽  
pp. e775-e782 ◽  
Author(s):  
Yukishige Hashimoto ◽  
Toshinori Matsushige ◽  
Koji Shimonaga ◽  
Masahiro Hosogai ◽  
Mayumi Kaneko ◽  
...  
Keyword(s):  
Vessel Wall ◽  
Intracranial Aneurysms ◽  
Vessel Wall Imaging ◽  
Atherosclerotic Lesions ◽  
Unruptured Intracranial Aneurysms ◽  
Wall Imaging

Visualizing wall enhancement over time in unruptured intracranial aneurysms using 3D vessel wall imaging

2018 ◽  
Vol 50 (1) ◽  
pp. 193-200 ◽  
Author(s):  
Bing Tian ◽  
Shahed Toossi ◽  
Laura Eisenmenger ◽  
Farshid Faraji ◽  
Megan K. Ballweber ◽  
...  
Keyword(s):  
Vessel Wall ◽  
Intracranial Aneurysms ◽  
Vessel Wall Imaging ◽  
Unruptured Intracranial Aneurysms ◽  
Over Time ◽  
Wall Imaging

Abstract WMP29: Contrast Enhancement Measurement of Unruptured Intracranial Aneurysms: A 3T High-Resolution Vessel Wall Imaging Validation Study

Stroke ◽  
2020 ◽  
Vol 51 (Suppl_1) ◽  
Author(s):  
Jorge A Roa ◽  
Mario Zanaty ◽  
Avery Pazour ◽  
Carlos Osorno-Cruz ◽  
Daizo Ishii ◽  
...  
Keyword(s):  
High Resolution ◽  
Contrast Enhancement ◽  
Vessel Wall ◽  
Intracranial Aneurysms ◽  
Roc Curves ◽  
Vessel Wall Imaging ◽  
Enhancement Ratio ◽  
Post Contrast ◽  
Unruptured Intracranial Aneurysms ◽  
Wall Imaging

Background: High-resolution vessel wall imaging (HR-VWI) has emerged as a valuable tool in assessing unruptured intracranial aneurysms (UIAs). There is no standardized method to quantify contrast enhancement of the aneurysmal wall. Contrast enhancement is reflected as signal intensity (SI) at the time of objective quantification. This study compares all the existing methods to objectively quantify contrast enhancement of UIAs. Methods: 3T HR-VWI was used to prospectively image patients with UIAs. Three different methods were analyzed in T1 pre- and post-contrast sequences: (1) circumferential aneurysm wall enhancement (CAWE) = mean post-contrast SI; (2) aneurysm-to-pituitary enhancement ratio (CR stalk ) = ratio of CAWE over pituitary stalk enhancement; and (3) enhancement ratio (ER) = max post-contrast SI - max pre-contrast SI/max pre-contrast SI x 100%. Known risks factors of aneurysm instability such as size ≥7mm and location in the anterior communicating (ACOM) and basilar arteries (BA) were used for analysis. Results: Forty-seven patients with 53 UIAs were included in the study. Mean age was 63.5 years, and 35 (74.5%) were women. UIAs ≥ 7mm showed significantly higher SI measurements for CAWE (273.1 vs 206.9, P =.05), CR stalk (0.49 vs 0.38, P =.006), and ER (85.7% vs 52.5%, P =.002) compared to smaller UIAs. SI was higher in UIAs located in the ACOM and BA (279.6 vs 235.7; 0.45 vs 0.44; 75.1% vs 61.3%) for CAWE, CR stalk and ER, respectively. ROC curves demonstrated sensitivity/specificity values of 0.74/0.64 for CAWE ≥ 205, 0.74/0.60 for CR stalk ≥ 0.398, and 0.71/0.73 for ER ≥ 62.1%. We found a moderately strong correlation between CAWE and CR stalk (Spearman = 0.69), CAWE and ER (Spearman = 0.52) and CR stalk and ER (Spearman = 0.47), with P <.001 in all cases. Conclusion: Three different methods: CAWE, CR stalk and ER may be used reliably to quantify SI in the wall of UIAs. Figure: ROC curves for (A) CAWE, (B) CR stalk and (C) ER.

scholarly journals Vessel Wall Imaging of Evolving Unruptured Intracranial Aneurysms

Stroke ◽  
2019 ◽  
Vol 50 (7) ◽  
pp. 1891-1894 ◽  
Author(s):  
Toshinori Matsushige ◽  
Koji Shimonaga ◽  
Daizo Ishii ◽  
Shigeyuki Sakamoto ◽  
Masahiro Hosogai ◽  
...  
Keyword(s):  
Vessel Wall ◽  
Intracranial Aneurysms ◽  
Vessel Wall Imaging ◽  
Unruptured Intracranial Aneurysms ◽  
Wall Imaging

scholarly journals Clinicopathological Insights From Vessel Wall Imaging of Unruptured Intracranial Aneurysms

Stroke ◽  
2018 ◽  
Vol 49 (10) ◽  
pp. 2516-2519 ◽  
Author(s):  
Koji Shimonaga ◽  
Toshinori Matsushige ◽  
Daizo Ishii ◽  
Shigeyuki Sakamoto ◽  
Masahiro Hosogai ◽  
...  
Keyword(s):  
Vessel Wall ◽  
Intracranial Aneurysms ◽  
Vessel Wall Imaging ◽  
Unruptured Intracranial Aneurysms ◽  
Wall Imaging

scholarly journals Decreased contrast enhancement on high-resolution vessel wall imaging of unruptured intracranial aneurysms in patients taking aspirin

2020 ◽  
pp. 1-7 ◽  
Author(s):  
Jorge A. Roa ◽  
Mario Zanaty ◽  
Daizo Ishii ◽  
Yongjun Lu ◽  
David K. Kung ◽  
...  
Keyword(s):  
High Resolution ◽  
Contrast Enhancement ◽  
Vessel Wall ◽  
Intracranial Aneurysms ◽  
Vessel Wall Imaging ◽  
Pituitary Stalk ◽  
Noninvasive Method ◽  
Aneurysmal Wall ◽  
Unruptured Intracranial Aneurysms ◽  
Wall Imaging

OBJECTIVEInflammation plays an integral role in the formation, growth, and progression to rupture of unruptured intracranial aneurysms (UIAs). Animal and human studies have suggested that, due to its antiinflammatory effect, aspirin (ASA) may decrease the risks of growth and rupture of UIAs. High-resolution vessel wall imaging (HR-VWI) has emerged as a noninvasive method to assess vessel wall inflammation and UIA instability. To the authors’ knowledge, to date no studies have found a significant correlation between patient use of ASA and contrast enhancement of UIAs on HR-VWI.METHODSThe University of Iowa HR-VWI Project database was analyzed. This database is a compilation of data on patients with UIAs who prospectively underwent HR-VWI on a 3T Siemens MRI scanner. The presence of aneurysmal wall enhancement was objectively defined using the aneurysm-to–pituitary stalk contrast ratio (CRstalk). This ratio was calculated by measuring the maximal signal intensity in the aneurysmal wall and the pituitary stalk on postcontrast T1-weighted images. Data on aneurysm size, morphology, and location and patient demographics and comorbidities were collected. Use of ASA was defined as daily intake of ≥ 81 mg during the previous 6 months or longer. Univariate and multivariate logistic regression analyses were performed to determine factors independently associated with increased contrast enhancement of UIAs on HR-VWI.RESULTSIn total, 74 patients harboring 96 UIAs were included in the study. The mean patient age was 64.7 ± 12.4 years, and 60 patients (81%) were women. Multivariate analysis showed that age (OR 1.12, 95% CI 1.05–1.19), aneurysm size ≥ 7 mm (OR 21.3, 95% CI 4.88–92.8), and location in the anterior communicating, posterior communicating, and basilar arteries (OR 10.7, 95% CI 2.45–46.5) were significantly associated with increased wall enhancement on HR-VWI. On the other hand, use of ASA was significantly associated with decreased aneurysmal wall enhancement on HR-VWI (OR 0.22, 95% CI 0.06–0.83, p = 0.026).CONCLUSIONSThe study results establish a correlation between use of ASA daily for ≥ 6 months and significant decreases in wall enhancement of UIAs on HR-VWI. The findings also demonstrate that detection of wall enhancement using HR-MRI may be a valuable noninvasive method for assessing aneurysmal wall inflammation and UIA instability.

scholarly journals Magnetic Resonance Vessel Wall Imaging in Human Intracranial Aneurysms

Stroke ◽  
2019 ◽  
Vol 50 (1) ◽  
Author(s):  
Joseph S. Hudson ◽  
Mario Zanaty ◽  
Daichi Nakagawa ◽  
David K. Kung ◽  
Pascal Jabbour ◽  
...  
Keyword(s):  
Magnetic Resonance ◽  
Vessel Wall ◽  
Intracranial Aneurysms ◽  
Vessel Wall Imaging ◽  
Wall Imaging

scholarly journals Circumferential wall enhancement in evolving intracranial aneurysms on magnetic resonance vessel wall imaging

2019 ◽  
Vol 131 (4) ◽  
pp. 1262-1268 ◽  
Author(s):  
Shunsuke Omodaka ◽  
Hidenori Endo ◽  
Kuniyasu Niizuma ◽  
Miki Fujimura ◽  
Takashi Inoue ◽  
...  
Keyword(s):  
Vessel Wall ◽  
Intracranial Aneurysms ◽  
Contrast Ratio ◽  
Multivariable Analysis ◽  
Vessel Wall Imaging ◽  
Fast Spin Echo ◽  
Unruptured Aneurysms ◽  
Ruptured Aneurysms ◽  
Aneurysm Wall ◽  
Wall Imaging

OBJECTIVERecent MR vessel wall imaging studies have indicated intracranial aneurysms in the active state could show circumferential enhancement along the aneurysm wall (CEAW). While ruptured aneurysms frequently show CEAW, CEAW in unruptured aneurysms at the evolving state (i.e., growing or symptomatic) has not been studied in detail. The authors quantitatively assessed the degree of CEAW in evolving unruptured aneurysms by comparing it separately to that in stable unruptured and ruptured aneurysms.METHODSA quantitative analysis of CEAW was performed in 26 consecutive evolving aneurysms using MR vessel wall imaging. Three-dimensional T1-weighted fast spin echo sequences were obtained before and after contrast media injection, and the contrast ratio of the aneurysm wall against the pituitary stalk (CRstalk) was calculated as the indicator of CEAW. Aneurysm characteristics of evolving aneurysms were compared with those of 69 stable unruptured and 67 ruptured aneurysms.RESULTSThe CRstalk values in evolving aneurysms were significantly higher than those in stable aneurysms (0.54 vs 0.34, p < 0.0001), and lower than those in ruptured aneurysms (0.54 vs 0.83, p < 0.0002). In multivariable analysis, CRstalk remained significant when comparing evolving with stable aneurysms (odds ratio [OR] 12.23, 95% confidence interval [CI] 3.53–42.41), and with ruptured aneurysms (OR 0.083, 95% CI 0.022–0.310).CONCLUSIONSThe CEAW in evolving aneurysms was higher than those in stable aneurysms, and lower than those in ruptured aneurysms. The degree of CEAW may indicate the process leading to rupture of intracranial aneurysms, which can be useful additional information to determine an indication for surgical treatment of unruptured aneurysms.

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