Study On The Relationship Between Aneurysm Wall Enhancement And Rupture Risk Of Intracranial Small Aneurysms Based On Vessel Wall-Magnetic Resonance Imaging

Objective: To explore the relationship between aneurysm wall enhancement(AWE)of intracranial small aneurysms and the risk of rupture based on vessel wall-magnetic resonance imaging(VW-MRI),so as to provide basis for the treatment and follow-up of intracranial small aneurysm.Methods: The clinical data of 111 patients with intracranial unruptured small saccular aneurysms(maximum diameter <7mm)examined by VW-MRI from September 2018 to November 2022 were collected retrospectively.Firstly,based on VW-MRI,the degree and type of aneurysm wall enhancement of intracranial small aneurysms were evaluated,and the aneurysm wall enhancement feature score was obtained.Secondly,the risk score of rupture of intracranial small aneurysms was obtained based on PHASES score and ELAPSS score.Then the intracranial small aneurysms were divided into non-enhanced group and enhanced group according to whether they were enhanced or not.The clinical risk factors [age,sex,history of hypertension,smoking and previous history of subarachnoid hemorrhage(SAH)] 、related morphological parameters(size,location and shape of aneurysm)and rupture risk score were compared between the two groups.Univariate analysis and multivariate logistic regression analysis were used to determine the significant differences between the two groups.The difference was statistically significant(P < 0.05).Finally,the aneurysm wall enhancement characteristics score and rupture risk score of intracranial small aneurysms in the enhancement group were screened,and the correlation between aneurysm wall enhancement and rupture risk of intracranial small aneurysms was determined by Spearman rank correlation analysis.Results: This study included 111 patients with intracranial unruptured saccular small aneurysms examined by VW-MRI with detailed clinical and imaging data,including 79 in non-enhanced group(65.3%)and 42 in enhanced group(34.7%).There were 68 female patients(61.3%)and 43 male patients(38.7%).The age range was 15 to 82 years old,with an average age of 55 ±11 years old,and the aneurysm size range was 1.4～6.9mm,with an average size of 3.5 ±1.3mm.Univariate analysis showed that sex,smoking history,hypertension history,past SAH history,aneurysm location and aneurysm shape were not the influencing factors of aneurysm wall enhancement of intracranial small aneurysms between the two groups(P > 0.05).There were significant differences in age,aneurysm size and risk of rupture between the two groups(P < 0.05).Binary logistic regression analysis was used to analyze the variables with P < 0.2,the results showed that age [odds ratio(oddsratio,OR)1.050,95% confidence interval(95%confidence interval,95%CI)1.007-1.096;P=0.021] and aneurysm size(OR 1.776,95%CI 1.293～2.440;P=0.000)were independently correlated with AWE.Based on the rupture risk score,the rupture risk in the enhanced group was significantly higher than that in the unenhanced group(P = 0.01).Spearman rank correlation analysis showed that there was a significant positive correlation between the aneurysm wall enhancement characteristics of intracranial small aneurysms and the risk of rupture in the enhanced group.Conclusions: Age and aneurysm size are independent influencing factors of aneurysm wall enhancement of intracranial small aneurysms.There is a certain correlation between aneurysm wall enhancement and rupture risk of intracranial small aneurysms.Observing the aneurysm wall enhancement of intracranial small aneurysms by VW-MRI can evaluate the risk of rupture to a certain extent,and provide relevant reference for the choice of treatment and follow-up.