Abstract
Characterization of the rupture risk factors for small intracranial aneurysms (SIAs, ≤5 mm) is clinically valuable. The present study aims to identify image-based morphological parameters and anatomical locations associated with the rupture status of SIAs. Two hundred and sixty-three patients with single SIAs (128 ruptured, 135 unruptured) were included, and six morphological parameters, including size, aspect ratio (AR), size ratio (SR), height–width ratio (H/W), flow angle (FA) and aneurysm width–parent artery diameter ratio, and the aneurysm locations were evaluated using three-dimensional geometry, and were used to identify a correlation with aneurysm rupture. Statistically significant differences were observed between ruptured and unruptured groups for AR, SR, H/W, FA, and aneurysm locations, from univariate analyses. Logistic regression analysis further revealed that AR (p = 0.034), SR (p = 0.004), H/W (p = 0.003), and FA (p < 0.001) had the strongest independent correlation with ruptured SIAs after adjustment for age, gender and other clinical risk factors. A future study on a larger SIA cohort need to establish to what extent the AR, SR, H/W and FA increase the risk of rupture in patients with unruptured SIAs in terms of absolute risks.
Highlights
Intracranial aneurysm (IA) is a prevalent vascular disorder affecting 2–5% of the population worldwide[1,2], and IA rupture frequently leads to fatal subarachnoid hemorrhage (SAH)
We identified that aneurysm flow angle (FA), size ratio (SR), aspect ratio (AR) and height–width ratio (H/W) ratio were significantly different between ruptured and unruptured SIAs
There were only a few reports about morphological parameters of SIAs in evaluating the rupture risk, the results of the current study may imply that, for SIAs that are suitable for observation or endovascular treatment, having these morphological risks factors and being located at anterior communicating artery (AcoA) site may need closer monitoring or more prompt intervention
Summary
Intracranial aneurysm (IA) is a prevalent vascular disorder affecting 2–5% of the population worldwide[1,2], and IA rupture frequently leads to fatal subarachnoid hemorrhage (SAH). To determine the most appropriate management plan for individual patients, we need to have a better understanding of the rupture risk of small IAs. Numerous studies in analyzing the morphological characteristics of IAs have demonstrated that geometric parameters such as aspect ratio (AR)[16,17], size ratio (SR)[18,19], and aneurysm inflow angle (FA)[20] are associated with aneurysm rupture status. Reported results on the aneurysm locations associated with rupture status are conflicting for small IAs. most of the studies agreed that the most prevalent location of ruptured small IAs was anterior communicating artery (AcoA)[21,22], in www.nature.com/scientificreports/.
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
