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Aneurysm wall enhancement, atherosclerotic proteins, and aneurysm size may be related in unruptured intracranial fusiform aneurysms

  • Magnetic Resonance
  • Published:
European Radiology Aims and scope Submit manuscript

A Commentary to this article was published on 22 May 2023

Abstract

Objective

This cross-sectional study aimed to investigate the associations between aneurysm wall enhancement (AWE), atherosclerotic protein levels, and aneurysm size in unruptured intracranial fusiform aneurysms (IFAs).

Methods

Patients with IFAs underwent high-resolution magnetic resonance imaging (HR-MRI) and atherosclerotic protein examinations from May 2015 to December 2021 were collected. A CRstalk (signal intensity [SI] of IFA wall/SI of pituitary stalk) > 0.60 was considered to indicate AWE. Atherosclerotic protein data was obtained from the peripheral blood. Aneurysmal characteristics included the maximal diameter of the cross-section (Dmax), location, type of IFA, presence of mural thrombus, and mural clots. Statistical analyses were performed with univariate analysis, logistic regression analysis, and Spearman’s correlation coefficient.

Results

Seventy-one IFAs from 71 patients were included in the study. Multivariate analysis revealed statin use (OR = 0.189, p = 0.026) and apolipoprotein B (Apo-B) level (OR = 6.019, p = 0.026) were the independent predictors of AWE in IFAs. In addition, statin use (OR = 0.813, p = 0.036) and Apo-B level (OR = 1.610, p = 0.003) were also the independent predictors of CRstalk. Additionally, we found that CRstalk and AWE were significantly positively associated with Dmax (rs = 0.409 and 0.349, respectively; p < 0.001 and p = 0.003, respectively).

Conclusions

There may be correlations between AWE, atherosclerotic protein levels, and aneurysm size in patients with IFAs. Apo-B and statin use were independent predictors of AWE in IFAs, which have the potential to be new therapeutic targets for IFAs.

Key Points

• There may be correlations between aneurysm wall enhancement, atherosclerotic protein levels in the peripheral blood, and aneurysm size in patients with intracranial fusiform aneurysms.

• Apolipoprotein B and statin use were independent predictors of aneurysm wall enhancement in intracranial fusiform aneurysms.

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Abbreviations

3D TOF:

Three-dimensional time-of-flight

Apo-A1:

Apolipoprotein A1

Apo-B:

Apolipoprotein B

AWE:

Aneurysm wall enhancement

CHO:

Total cholesterol

CRstalk :

Signal intensity of IFA wall/signal intensity of pituitary stalk

HDL:

High-density lipoprotein

HR-MRI:

High-resolution magnetic resonance imaging

IAs:

Intracranial aneurysms

IFAs:

Intracranial fusiform aneurysms

LDL:

Low-density lipoprotein

MPR:

Multiplanar reconstruction

ROI:

Region of interest

SI:

Signal intensity

SIAs:

Saccular intracranial aneurysms

TG:

Triglycerides

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Funding

This work was supported by the National Natural Science Foundation of China (No. 82171290; 81771233), Natural Science Foundation of Beijing Municipality (No. 7222050, L192013), Beijing Municipal Administration of Hospitals’ Ascent Plan (DFL20190501), and Horizontal Project in Beijing Tiantan Hospital (HX-A-027 [2021]), and Research and Promotion Program of Appropriate Techniques for Intervention of Chinese High-Risk Stroke People (GN-2020R0007), and BTH Coordinated Development—Beijing Science and Technology Planning Project (Z181100009618035), and Beijing Municipal Administration of Hospitals’ Ascent Plan (DFL20190501), and Beijing Natural Science Foundation (L192013; 22G10396). The funders (other than the named authors) had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

Author information

Author notes

  1. Fei Peng and Hao Niu contributed equally to this article.

  2. Xingquan Zhao and Aihua Liu are corresponding authors who contributed equally to this article.

Authors and Affiliations

  1. Neurointerventional Center, Beijing Neurosurgical Institute, Capital Medical University, Beijing, 100070, China

    Fei Peng, Hao Niu, Jigang Chen, Xin Tong, Jiaxiang Xia, Xiaoxin He, Boya Xu, Xuge Chen & Aihua Liu

  2. Department of Interventional Neuroradiology, Beijing Tiantan Hospital, Capital Medical University, Beijing, 100070, China

    Fei Peng, Hao Niu, Jigang Chen, Xin Tong, Jiaxiang Xia, Xiaoxin He, Boya Xu, Xuge Chen & Aihua Liu

  3. Department of Cerebrovascular Surgery, Engineering Technology Research Center of Education Ministry of China On Diagnosis and Treatment of Cerebrovascular Disease, Neurosurgery Center, Zhujiang Hospital, Southern Medical University, Guangzhou, 510280, Guangdong, China

    Xin Feng

  4. Department of Neurosurgery, The Third Xiangya Hospital, Central South University, Changsha, Hunan, China

    Lang Liu

  5. Department of Neurosurgery, Hengyang Medical School, The Second Affiliated Hospital, University of South China, Hengyang, Hunan, China

    Peng Xu & Yonghong Duan

  6. Operating Room, Heze Municipal Hospital, Heze, Shandong, China

    Hong Zhang

  7. Tiantan Neuroimaging Center of Excellence, China National Clinical Research Center for Neurological Diseases, No. 119, South 4Th Ring West Road, Fengtai District, Beijing, 100070, China

    Binbin Sui, Xingquan Zhao & Aihua Liu

  8. Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China

    Xingquan Zhao

Authors
  1. Fei Peng
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Corresponding authors

Correspondence to Xingquan Zhao or Aihua Liu.

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Peng, F., Niu, H., Feng, X. et al. Aneurysm wall enhancement, atherosclerotic proteins, and aneurysm size may be related in unruptured intracranial fusiform aneurysms. Eur Radiol 33, 4918–4926 (2023). https://doi.org/10.1007/s00330-023-09456-9

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