scholarly journals Multi-View Convolutional Neural Networks in Rupture Risk Assessment of Small, Unruptured Intracranial Aneurysms

2021 ◽  
Vol 11 (4) ◽  
pp. 239
Author(s):  
Jun Hyong Ahn ◽  
Heung Cheol Kim ◽  
Jong Kook Rhim ◽  
Jeong Jin Park ◽  
Dick Sigmund ◽  
...  
Keyword(s):  
Risk Prediction ◽  
Intracranial Aneurysms ◽  
Three Dimensional ◽  
Cerebral Aneurysms ◽  
Rupture Risk ◽  
Single Image ◽  
Anterior Circulation ◽  
Single View ◽  
Unruptured Intracranial Aneurysms ◽  
Sensitivity Specificity

Auto-detection of cerebral aneurysms via convolutional neural network (CNN) is being increasingly reported. However, few studies to date have accurately predicted the risk, but not the diagnosis itself. We developed a multi-view CNN for the prediction of rupture risk involving small unruptured intracranial aneurysms (UIAs) based on three-dimensional (3D) digital subtraction angiography (DSA). The performance of a multi-view CNN-ResNet50 in accurately predicting the rupture risk (high vs. non-high) of UIAs in the anterior circulation measuring less than 7 mm in size was compared with various CNN architectures (AlexNet and VGG16), with similar type but different layers (ResNet101 and ResNet152), and single image-based CNN (single-view ResNet50). The sensitivity, specificity, and overall accuracy of risk prediction were estimated and compared according to CNN architecture. The study included 364 UIAs in training and 93 in test datasets. A multi-view CNN-ResNet50 exhibited a sensitivity of 81.82 (66.76–91.29)%, a specificity of 81.63 (67.50–90.76)%, and an overall accuracy of 81.72 (66.98–90.92)% for risk prediction. AlexNet, VGG16, ResNet101, ResNet152, and single-view CNN-ResNet50 showed similar specificity. However, the sensitivity and overall accuracy were decreased (AlexNet, 63.64% and 76.34%; VGG16, 68.18% and 74.19%; ResNet101, 68.18% and 73.12%; ResNet152, 54.55% and 72.04%; and single-view CNN-ResNet50, 50.00% and 64.52%) compared with multi-view CNN-ResNet50. Regarding F1 score, it was the highest in multi-view CNN-ResNet50 (80.90 (67.29–91.81)%). Our study suggests that multi-view CNN-ResNet50 may be feasible to assess the rupture risk in small-sized UIAs.

Rapid Growth of Cerebral Aneurysms Before Rupture

2007 ◽  
Author(s):  
Liang-Der Jou ◽  
Deok Hee Lee ◽  
Michel E. Mawad
Keyword(s):  
Intracranial Aneurysms ◽  
Cerebral Aneurysms ◽  
International Study ◽  
Anterior Communicating Artery ◽  
Anatomical Location ◽  
Rupture Risk ◽  
Poor Clinical Outcome ◽  
Patient History ◽  
Unruptured Intracranial Aneurysms ◽  
Ruptured Intracranial Aneurysms

Ruptured intracranial aneurysms often have poor clinical outcome. International Study on Unruptured Intracranial Aneurysms has demonstrated the value of treatment for unruptured intracranial aneurysms and that aneurysms larger than 7mm may benefit from treatment. Although aneurysm size appears to be the major indication for rupture, other risk factors, including anatomical location and patient history, are also important in clinical evaluation and cannot be overlooked. Aneurysms at the anterior communicating artery (ACoA) especially have higher rupture risk and rupture at smaller sizes than other aneurysms.

scholarly journals Increased rupture risk in small intracranial aneurysms associated with methamphetamine use

2020 ◽  
pp. 159101992095953
Author(s):  
Dylan Noblett ◽  
Lotfi Hacein-Bey ◽  
Ben Waldau ◽  
Jordan Ziegler ◽  
Brian Dahlin ◽  
...  
Keyword(s):  
Intracranial Aneurysms ◽  
Aneurysmal Subarachnoid Hemorrhage ◽  
Significant Risk ◽  
Retrospective Chart Review ◽  
Anterior Circulation ◽  
Unruptured Aneurysms ◽  
Methamphetamine Use ◽  
Aneurysm Size ◽  
Unruptured Intracranial Aneurysms ◽  
History Of

Background Aneurysmal subarachnoid hemorrhage (SAH) is the most common cause of nontraumatic SAH. Current guidelines generally recommend observation for unruptured intracranial aneurysms smaller than 7 mm, for those are considered at low risk for spontaneous rupture according to available scoring systems. Objective We observed a tendency for SAH in small intracranial aneurysms in patients who are methamphetamine users. A retrospective, single center study to characterize the size and location of ruptured and unruptured intracranial aneurysms in methamphetamine users was performed. Materials and methods Clinical characteristics and patient data were collected via retrospective chart review of patients with intracranial aneurysms and a history of methamphetamine use with a specific focus on aneurysm size and location. Results A total of 62 patients were identified with at least one intracranial aneurysm and a history of methamphetamine use, yielding 73 intracranial aneurysms (n = 73). The mean largest diameter of unruptured aneurysms (n = 44) was 5.1 mm (median 4.5, SD 2.5 mm), smaller than for ruptured aneurysms (n = 29) with a mean diameter of 6.3 mm (median 5.5, SD 2.5 mm). Aneurysms measuring less than 7 mm presented with SAH in 36.5%. With regard to location, 28% (n = 42) of anterior circulation aneurysms less than 7 mm presented with rupture, in contrast to 70% (n = 10) of posterior circulation aneurysms which were found to be ruptured. Conclusions Methamphetamine use may be considered a significant risk factor for aneurysmal SAH at a smaller aneurysm size than for other patients. These patients may benefit from a lower threshold for intervention and/or aggressive imaging and clinical follow-up.

Embolization of Non-Ruptured Aneurysms

1999 ◽  
Vol 5 (1_suppl) ◽  
pp. 93-96 ◽  
Author(s):  
C.F. Dowd ◽  
C.C. Phatouros ◽  
A.M. Malek ◽  
T.E. Lempert ◽  
P.M. Meyers ◽  
...  
Keyword(s):  
Intracranial Aneurysms ◽  
Three Dimensional ◽  
Giant Aneurysm ◽  
Epidemiological Data ◽  
Anterior Circulation ◽  
Unruptured Aneurysms ◽  
Aneurysm Neck ◽  
Technical Developments ◽  
History Of ◽  
Anterior Circulation Aneurysms

Options for treatment of intracranial aneurysms have expanded with the advent of the Guglielmi Detachable Cod (GDC) eight years ago. We have reviewed 435 cases of intracranial aneurysms treated at UCSF by endovascular means using the GDC system. Of these, 55% represent anterior circulation aneurysms, and 45% are located in the posterior circulation. Additionally, 55% of the aneurysms presented with subarachnoid hemorrhage (SAH) and 45% were unruptured. Factors which hindered optimal coiling include the following: wide aneurysm neck in relation to the overall aneurysm size, mural thrombus, giant aneurysm, arteries originating from the aneurysm sac, and middle cerebral location. After initial experience was gained, we tended to avoid these aneurysms especially in the non-ruptured group. This may be especially important in light of new epidemiological data suggesting that the natural history of unruptured aneurysms is significantly lower than previously thought. New technical developments which may reduce the risk of treating unruptured aneurysms include the two-dimensional coil, the three-dimensional coil, the balloon-assist technique for wide-necked aneurysms, and combined stent-coil procedures.

Abstract W P81: Intracranial Aneurysms and Their Relationship to Circle of Willis Variations: A Retrospective Analysis of Patients in a University Hospital

Stroke ◽  
2015 ◽  
Vol 46 (suppl_1) ◽  
Author(s):  
Dhanya Anand ◽  
Steve M Cordina
Keyword(s):  
Intracranial Aneurysms ◽  
Vascular System ◽  
Cerebral Aneurysms ◽  
University Hospital ◽  
Superior Cerebellar Artery ◽  
P Value ◽  
Anterior Circulation ◽  
Arterial Variations ◽  
Cerebellar Artery ◽  
Intracranial Vasculature

Background: Cerebral aneurysms, their rupture and resultant neurological sequelae are a major cause of morbidity and mortality. Multiple studies have analyzed the etiology of cerebral aneurysms including hemodynamic and congenital factors. Since the arterial supply of the brain develops entirely from the third pharyngeal arch and the dorsal aorta, any insult to the developing vascular system increases the probability of development of variations, including aneurysms. Purpose: To identify the association of arterial variations with aneurysms. Methods: A total of 83 patients with 106 intracranial aneurysms diagnosed by cerebral angiography from January 2011 to July 2014 were analyzed for variations in the intracranial vasculature. The type and laterality of the vascular variants in relation to the aneurysms were also examined. Results: On evaluation of the aneurysms, 65 (61.3 %) had associated variations in the intracranial vasculature. Among these, 51 (78.5 %) had variations ipsilateral to the aneurysm. 90 (84.9%) were in the anterior circulation. 52 patients (62.7%) were female. Various vascular variations including hypoplasia of posterior communicating (P-Comm) artery (56.5 %), variant anterior cerebral (ACA) artery (17.39%), fetal type posterior cerebral (PCA) artery (21.7%), fenestration of vertebral artery (1.4%), superior cerebellar artery duplication (1.4%) and arteriovenous malformations were noted. Fetal type PCAs were significantly more common in patients with anterior communicating (A-comm) (p-value <0.0115) and P-Comm A aneurysms (p-value <0.0131). Also, variations of A1 segment of ACA were significantly more common in A-Comm aneurysms (p-value <0.0013). Conclusions: The distribution of aneurysms in the intracranial vasculature in our study is comparable to previous literature. Among the arterial variations we found that fetal type PCAs are significantly common among A-Comm and P-Comm aneurysms. Also, variations in the A1 segment of ACAs were commonly associated with A-Comm aneurysms. Although further conformation of these associations is required with a prospective randomized control trial, if established, screening for these variations could help in primary prevention and early treatment of these aneurysms.

Asymptomatic Ischemic Risks in Microsurgical Clipping for Unruptured Intracranial Aneurysms in Anterior Circulation

2017 ◽  
Vol 108 ◽  
pp. 418-426 ◽  
Author(s):  
Katsuhiro Shinagawa ◽  
Toshinori Matsushige ◽  
Takahito Okazaki ◽  
Daizo Ishii ◽  
Nobuhiko Ichinose ◽  
...  
Keyword(s):  
Intracranial Aneurysms ◽  
Anterior Circulation ◽  
Microsurgical Clipping ◽  
Unruptured Intracranial Aneurysms

Three-dimensional Reconstructed Images after Rotational Angiography in the Evaluation of Intracranial Aneurysms: Surgical Correlation

Neurosurgery ◽  
2000 ◽  
Vol 47 (4) ◽  
pp. 866-871 ◽  
Author(s):  
Shuichi Tanoue ◽  
Hiro Kiyosue ◽  
Hiroyuki Kenai ◽  
Takaharu Nakamura ◽  
Masanori Yamashita ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Intracranial Aneurysms ◽  
Surface Display ◽  
Three Dimensional ◽  
Cerebral Aneurysms ◽  
Maximum Intensity Projection ◽  
Rotational Angiography ◽  
Neck Size ◽  
Visualization Techniques ◽  
Biplane Angiography

Abstract OBJECTIVE To evaluate the diagnostic accuracy of three-dimensional reconstructed images from rotational subtraction angiography in the surgical treatment of intracranial aneurysms. METHODS Twenty-two patients with 34 intracranial aneurysms underwent biplane angiography (40 degrees per s, 4.5 degrees per image, 8.8 frames per s). Three-dimensional (3-D) reconstructed images were obtained at a separate Advantage 3.1 workstation (General Electric, Milwaukee, WI) after the rotational images were transferred. The available visualization techniques included maximum intensity projection, shaded surface display, and virtual endoluminal view. All images were evaluated in correlation with intrasurgical visual data recorded on videotapes. RESULTS 3-D reconstructed images correlated well with surgical findings. The shape of the aneurysms, their neck size, and their relationships to the parent vessels and other branches were depicted clearly, especially compared with images obtained by two-dimensional conventional subtraction angiography and magnetic resonance angiography. CONCLUSION 3-D subtraction angiography enables the surgeon to understand the 3-D structure of lesions and is very useful in planning the surgical treatment of cerebral aneurysms.

Expanding the use of flow diverters beyond their initial indication: treatment of small unruptured aneurysms

2017 ◽  
Vol 10 (3) ◽  
pp. 245-248 ◽  
Author(s):  
J M Pumar ◽  
A Mosqueira ◽  
H Cuellar ◽  
B Dieguez ◽  
L Guimaraens ◽  
...  
Keyword(s):  
Intracranial Aneurysms ◽  
Cerebral Aneurysms ◽  
Flow Diverter ◽  
Clinical Findings ◽  
Anterior Circulation ◽  
Unruptured Aneurysms ◽  
Patient Demographics ◽  
Delayed Hemorrhage ◽  
Mean Size ◽  
Unruptured Cerebral Aneurysms

BackgroundExperience with the endovascular treatment of unruptured small intracranial aneurysms by flow diverter devices is still limited.ObjectiveTo assess the safety and efficacy of the SILK flow diverter (SFD) in the treatment of small unruptured cerebral aneurysms (<10 mm).MethodsWe performed a retrospective review of a prospectively maintained database of patients treated with a SFD between July 2008 and December 2013 at 4 institutions in Spain to identify all patients with small unruptured aneurysms (<10 mm). Data for patient demographics, aneurysm characteristics, and technical procedures were analyzed. Angiographic and clinical findings were recorded during the procedure and at 6- and 12-month follow-ups.ResultsA total of 109 small aneurysms were treated with a SFD in 104 patients (78 women; 26 men; mean, median, and range of age: 55.2, 57.1, and 19–80 years, respectively). A total of 60 patients were asymptomatic (57.7%). All except 7 aneurysms (6.4%) arose from the anterior circulation. The mean size of the aneurysms was 4.7±1.9 mm. At 6 months, the neuromorbidity and neuromortality rates were 2.9% and 0.9%, respectively. Imaging at the 12-month follow-up showed complete occlusion, neck remnants, and residual aneurysm in 88.5% (69/78), 7.7% (6/78), and 3.3% (3/78) of cases, respectively. No delayed hemorrhage occurred.ConclusionsThe findings suggest that the indications for SFD can be safely extended to small intracranial aneurysms.

Growth and Rupture Risk of Small Unruptured Intracranial Aneurysms

2017 ◽  
Vol 167 (1) ◽  
pp. 26 ◽  
Author(s):  
Ajay Malhotra ◽  
Xiao Wu ◽  
Howard P. Forman ◽  
Holly K. Grossetta Nardini ◽  
Charles C. Matouk ◽  
...  
Keyword(s):  
Intracranial Aneurysms ◽  
Rupture Risk ◽  
Unruptured Intracranial Aneurysms
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