Document Detail


Morphology parameters for intracranial aneurysm rupture risk assessment.
MedLine Citation:
PMID:  18797347     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: The aim of this study is to identify image-based morphological parameters that correlate with human intracranial aneurysm (IA) rupture.
METHODS: For 45 patients with terminal or sidewall saccular IAs (25 unruptured, 20 ruptured), three-dimensional geometries were evaluated for a range of morphological parameters. In addition to five previously studied parameters (aspect ratio, aneurysm size, ellipticity index, nonsphericity index, and undulation index), we defined three novel parameters incorporating the parent vessel geometry (vessel angle, aneurysm [inclination] angle, and [aneurysm-to-vessel] size ratio) and explored their correlation with aneurysm rupture. Parameters were analyzed with a two-tailed independent Student's t test for significance; significant parameters (P < 0.05) were further examined by multivariate logistic regression analysis. Additionally, receiver operating characteristic analyses were performed on each parameter.
RESULTS: Statistically significant differences were found between mean values in ruptured and unruptured groups for size ratio, undulation index, nonsphericity index, ellipticity index, aneurysm angle, and aspect ratio. Logistic regression analysis further revealed that size ratio (odds ratio, 1.41; 95% confidence interval, 1.03-1.92) and undulation index (odds ratio, 1.51; 95% confidence interval, 1.08-2.11) had the strongest independent correlation with ruptured IA. From the receiver operating characteristic analysis, size ratio and aneurysm angle had the highest area under the curve values of 0.83 and 0.85, respectively.
CONCLUSION: Size ratio and aneurysm angle are promising new morphological metrics for IA rupture risk assessment. Because these parameters account for vessel geometry, they may bridge the gap between morphological studies and more qualitative location-based studies.
Authors:
Sujan Dhar; Markus Tremmel; J Mocco; Minsuok Kim; Junichi Yamamoto; Adnan H Siddiqui; L Nelson Hopkins; Hui Meng
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, Non-P.H.S.    
Journal Detail:
Title:  Neurosurgery     Volume:  63     ISSN:  1524-4040     ISO Abbreviation:  Neurosurgery     Publication Date:  2008 Aug 
Date Detail:
Created Date:  2008-09-17     Completed Date:  2009-04-21     Revised Date:  2014-09-08    
Medline Journal Info:
Nlm Unique ID:  7802914     Medline TA:  Neurosurgery     Country:  United States    
Other Details:
Languages:  eng     Pagination:  185-96; discussion 196-7     Citation Subset:  IM    
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MeSH Terms
Descriptor/Qualifier:
Aneurysm, Ruptured / pathology,  radiography*
Cerebral Angiography / methods*,  standards
Female
Humans
Imaging, Three-Dimensional / methods*,  standards
Intracranial Aneurysm / pathology,  radiography*
Male
Risk Assessment
Grant Support
ID/Acronym/Agency:
EB002873/EB/NIBIB NIH HHS; K25 NS047242/NS/NINDS NIH HHS; K25 NS047242-05/NS/NINDS NIH HHS; NS043924/NS/NINDS NIH HHS; NS047242/NS/NINDS NIH HHS
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