Document Detail


Size Ratio Performance in Detecting Cerebral Aneurysm Rupture Status is Insensitive to Small Vessel Removal.
MedLine Citation:
PMID:  23246822     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
BACKGROUND:: The variable definition of Size Ratio (SR) for sidewall (SW) vs. bifurcation (BIF) aneurysms raises confusion for lesions harboring small branches such as carotid ophthalmic or posterior communicating locations. These aneurysms are considered SW by many clinicians, while SR methodology classifies them as BIF. OBJECTIVE:: To evaluate the effect of ignoring small vessels and SW vs. stringent BIF labeling on SR ruptured aneurysm detection performance in borderline aneurysms with small branches, and to reconcile SR-based labeling with clinical SW/BIF classification. METHODS:: Catheter rotational angiographic datasets of 134 consecutive aneurysms (60 ruptured) were automatically measured in 3-D. Stringent BIF labeling was applied to clinically labeled aneurysms, with 21 aneurysms switching label from SW to BIF. Parent vessel size was evaluated both taking into account, and ignoring, small vessels. SR was defined accordingly, as the ratio between aneurysm and parent vessel sizes. Univariate and multivariate statistics identified significant features. The square of the correlation coefficient (R-square) was reported for bivariate analysis of alternative SR calculations. RESULTS:: Regardless of SW/BIF labeling method, SR was equally significant in discriminating aneurysm ruptured status (p-value <0.001). Bivariate analysis of alternative SR had a high correlation of R-square=0.94 on the whole dataset, and R-square=0.98 on the 21 borderline aneurysms. CONCLUSION:: Ignoring small branches from SR calculation maintains rupture status detection performance, while reducing post-processing complexity and removing labeling ambiguity. Aneurysms adjacent to these vessels can be considered sidewall for morphometric analysis. It is reasonable to use the clinical SW/BIF labeling when employing SR for rupture risk evaluation.
Authors:
Alexandra Lauric; Merih I Baharoglu; Adel M Malek
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-12-14
Journal Detail:
Title:  Neurosurgery     Volume:  -     ISSN:  1524-4040     ISO Abbreviation:  Neurosurgery     Publication Date:  2012 Dec 
Date Detail:
Created Date:  2012-12-18     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7802914     Medline TA:  Neurosurgery     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
Cerebrovascular and Endovascular Division, Department of Neurosurgery, Tufts Medical Center and Tufts University School of Medicine. Boston, MA 02111, USA.
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