Incidence of growth and rupture of unruptured intracranial aneurysms followed by serial MRA

Abstract

The natural history, including growth and rupture, of unruptured intracranial aneurysms (UIAs) remains unknown. Here, we present the results of serial magnetic resonance angiography (MRA) follow-up study in 111 patients with 136 UIAs. A total of 111 patients with 136 UIAs were followed annually over the past 12years, using 1.5-Tesla MRA. Follow-up was ended when UIAs were treated surgically, or the patients died of subarachnoid hemorrhage or other causes. Various factors influencing aneurysm rupture or growth were examined statistically. Aneurysm rupture and growth occurred in six and 13 of the 111 patients, respectively. Annual rupture rate was 1.8% per year and annual growth rate was 3.9% per year. Aneurysm size was the sole factor influencing rupture(H.R. 1.214, 95% CI, 1.078-1.368) and multiplicity was the sole factor influencing aneurysm growth (H.R. 5.174, 95% CI 1.81-14.80). Serial MRA study showed that the incidence of UIA growth was twice as high as that of UIA rupture. As four patients showed aneurysm rupture or growth within 1year, further investigations are necessary to determine the optimum interval of radiological investigation and to identify which UIAs grow or rupture within a short time.