Systemic immune-inflammation index is associated with aneurysmal wall enhancement in unruptured intracranial fusiform aneurysms

Abstract

IntroductionInflammation plays a key role in the progression of intracranial aneurysms. Aneurysmal wall enhancement (AWE) correlates well with inflammatory processes in the aneurysmal wall. Understanding the potential associations between blood inflammatory indices and AWE may aid in the further understanding of intracranial aneurysm pathophysiology.MethodsWe retrospectively reviewed 122 patients with intracranial fusiform aneurysms (IFAs) who underwent both high-resolution magnetic resonance imaging and blood laboratory tests. AWE was defined as a contrast ratio of the signal intensity of the aneurysmal wall to that of the pituitary stalk ≥ 0.90. The systemic immune-inflammation (SII) index (neutrophils × platelets/lymphocytes) was calculated from laboratory data and dichotomized based on whether or not the IFA had AWE. Aneurysmal symptoms were defined as sentinel headache or oculomotor nerve palsy. Multivariable logistic regression and receiver operating characteristic curve analyses were performed to determine how well the SII index was able to predict AWE and aneurysmal symptoms. Spearman’s correlation coefficients were used to explore the potential associations between variables.ResultsThis study included 95 patients, of whom 24 (25.3%) presented with AWE. After adjusting for baseline differences in neutrophil to lymphocyte ratios, leukocytes, and neutrophils in the multivariable logistic regression analysis, smoking history (P = 0.002), aneurysmal symptoms (P = 0.047), maximum diameter (P = 0.048), and SII index (P = 0.022) all predicted AWE. The SII index (P = 0.038) was the only independent predictor of aneurysmal symptoms. The receiver operating characteristic curve analysis revealed that the SII index was able to accurately distinguish IFAs with AWE (area under the curve = 0.746) and aneurysmal symptoms (area under the curve = 0.739).DiscussionAn early elevation in the SII index can independently predict AWE in IFAs and is a potential new biomarker for predicting IFA instability.

Metabolic alterations of peripheral blood immune cells and heterogeneity of neutrophil in intracranial aneurysms patients

“…Inflammatory processes play a significant role in the development of IA 30,31 . Several research exploring the association between chronic inflammation and IAs suggested that persistent disruption of the peripheral immune environment may induce the formation of IAs through inflammatory cascades 32–35 . In the present, it was observed that PBMCs, as a crucial component of the peripheral immune environment, exhibited metabolic dysregulation associated with numerous diseases.…”

“… 30 , 31 Several research exploring the association between chronic inflammation and IAs suggested that persistent disruption of the peripheral immune environment may induce the formation of IAs through inflammatory cascades. 32 , 33 , 34 , 35 In the present, it was observed that PBMCs, as a crucial component of the peripheral immune environment, exhibited metabolic dysregulation associated with numerous diseases. In our study, metabolic profiling of PBMCs revealed distinct metabolic characteristics among different subsets.…”

Association between preoperative systemic immune inflammation index and postoperative sepsis in patients with intestinal obstruction: A retrospective observational cohort study

“…Man Xu et al reported in a retrospective cohort study of 13,929 middle‐aged and elderly people that SII can be used as a useful indicator to clarify the interaction between thrombocytosis and immune inflammation in the occurrence and development of cerebral vascular disease in middle‐aged and elderly people 34 . Other studies also reported the potential role of SII in cardiocerebral vascular disease 35–37 . A higher SII has also been associated with an increased risk of POCD, 38 rheumatoid arthritis, 39 and postoperative pulmonary complications 40 …”

“… 34 Other studies also reported the potential role of SII in cardiocerebral vascular disease. 35 , 36 , 37 A higher SII has also been associated with an increased risk of POCD, 38 rheumatoid arthritis, 39 and postoperative pulmonary complications. 40 …”

“…34 Other studies also reported the potential role of SII in cardiocerebral vascular disease. [35][36][37] A higher SII has also been associated with an increased risk of POCD, 38 rheumatoid arthritis, 39 and postoperative pulmonary complications. 40 The PLT, neutrophil, and LYMPHs could all be examined routinely and easily in patients undergoing selective and emergency procedures, making the marker available to doctors in our daily practice.…”