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

Eur Radiol. 2023 Jul;33(7):4918-4926. doi: 10.1007/s00330-023-09456-9. Epub 2023 Feb 25.

Authors

Fei Peng^#^{1

2}, Hao Niu^#^{1

2}, Xin Feng³, Lang Liu⁴, Peng Xu⁵, Hong Zhang⁶, Jigang Chen^{1

2}, Xin Tong^{1

2}, Jiaxiang Xia^{1

2}, Xiaoxin He^{1

2}, Boya Xu^{1

2}, Xuge Chen^{1

2}, Binbin Sui⁷, Yonghong Duan⁵, Xingquan Zhao^#^{8

9}, Aihua Liu^#^{10

11

12}

Affiliations

¹ Neurointerventional Center, Beijing Neurosurgical Institute, Capital Medical University, Beijing, 100070, China.
² Department of Interventional Neuroradiology, Beijing Tiantan Hospital, Capital Medical University, Beijing, 100070, China.
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.
⁴ Department of Neurosurgery, The Third Xiangya Hospital, Central South University, Changsha, Hunan, China.
⁵ Department of Neurosurgery, Hengyang Medical School, The Second Affiliated Hospital, University of South China, Hengyang, Hunan, China.
⁶ Operating Room, Heze Municipal Hospital, Heze, Shandong, China.
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.
⁸ 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. zxq@vip.163.com.
⁹ Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China. zxq@vip.163.com.
¹⁰ Neurointerventional Center, Beijing Neurosurgical Institute, Capital Medical University, Beijing, 100070, China. liuaihuadoctor@163.com.
¹¹ Department of Interventional Neuroradiology, Beijing Tiantan Hospital, Capital Medical University, Beijing, 100070, China. liuaihuadoctor@163.com.
¹² 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. liuaihuadoctor@163.com.

^# Contributed equally.

PMID: 36840766
DOI: 10.1007/s00330-023-09456-9

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 CR_stalk (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 (D_max), 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 CR_stalk. Additionally, we found that CR_stalk and AWE were significantly positively associated with D_max (r_s = 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.

Keywords: Aneurysm; Apolipoproteins B; Hydroxymethylglutaryl-CoA reductase inhibitors; Magnetic resonance imaging.

© 2023. The Author(s), under exclusive licence to European Society of Radiology.

MeSH terms

Apolipoproteins
Cross-Sectional Studies
Humans
Hydroxymethylglutaryl-CoA Reductase Inhibitors* / therapeutic use
Intracranial Aneurysm* / diagnostic imaging
Intracranial Aneurysm* / pathology
Magnetic Resonance Imaging / methods
Thrombosis*

Substances

Hydroxymethylglutaryl-CoA Reductase Inhibitors
Apolipoproteins