Abdominal Aortic Calcification Volume Is Associated with Wall Enhancement of Unruptured Intracranial Aneurysm

Abstract

Inflammatory atherosclerotic remodeling of unruptured intracranial aneurysms (UIAs) wall, which could be detected as aneurysm wall enhancement (AWE) in MR vessel wall imaging (VWI), plays a pivotal role in pathophysiology of progression to rupture. On the other hand, abdominal aortic calcification reflects the extent of systemic atherosclerosis, which in turn predicts the risk of atherosclerotic cardiovascular as well as cerebrovascular diseases. This study sought to investigate whether the abdominal aortic calcification was associated with increased wall enhancement of UIAs in VWI. This retrospective study reviewed subjects who underwent evaluation using 3T MR-VWI of UIAs and abdominal CT before endovascular treatments for UIAs between 2018 to 2020. Abdominal aortic calcification volume (ACV) was quantitatively measured from abdominal CT scans between renal arteries and bifurcation. The presence of AWE was correlated with patient profile, aneurysm morphology, and the ACV. A total of 42 patients with 50 UIAs were included. AWE was detected in 19 (38.0%) UIAs. Maximum diameter (9.2 ± 5.0 mm vs 5.3 ± 1.5 mm, P < 0.01) and the ACV (8.2 ± 6.0 mL vs 4.7 ± 4.6 mL, P= 0.038) were significantly higher in UIAs with AWE than those without AWE. The ACV was significantly associated with increased wall enhancement of UIAs. Systemic atherosclerosis might be a risk factor for the instability of UIAs. Future studies examining the effect of medications for systemic atherosclerosis on the extent of AWE in UIAs is warranted.