Vessel Wall Imaging of Intracranial Aneurysms: Systematic Review and Meta-analysis

Texakalidis, Pavlos; Hilditch, Christopher Alan; Lehman, Vance T.; Lanzino, Giuseppe; Pereira, Vítor Mendes; Brinjikji, Waleed

doi:10.1016/j.wneu.2018.06.008

Cited by 74 publications

(70 citation statements)

References 20 publications

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“…Additionally, the NPV was also high (96%), suggesting that the absence of the AWE is strongly associated with IA stability [35]. It is also important to note that a sizeable proportion of IAs with AWE are stable, reflected by a PPV = 56% for instability [35]. This study suggested that the IAs with AWE are diverse in their stability.…”

Section: Discussionmentioning

confidence: 68%

“…In our study, AWE did not have a high PPV for MBs associated with SH, but lack of AWE had a high NPV. A recent meta-analysis revealed that the sensitivity of the AWE for identifying unstable IAs was high (95%) [35]. Additionally, the NPV was also high (96%), suggesting that the absence of the AWE is strongly associated with IA stability [35].…”

Section: Discussionmentioning

confidence: 99%

“…A recent meta-analysis revealed that the sensitivity of the AWE for identifying unstable IAs was high (95%) [35]. Additionally, the NPV was also high (96%), suggesting that the absence of the AWE is strongly associated with IA stability [35]. It is also important to note that a sizeable proportion of IAs with AWE are stable, reflected by a PPV = 56% for instability [35].…”

Section: Discussionmentioning

confidence: 99%

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Quantitative Susceptibility Mapping and Vessel Wall Imaging as Screening Tools to Detect Microbleed in Sentinel Headache

Ishii

Nakagawa

Zanaty

et al. 2020

JCM

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Background: MR-quantitative susceptibility mapping (QSM) can identify microbleeds (MBs) in intracranial aneurysm (IA) wall associated with sentinel headache (SH) preceding subarachnoid hemorrhage. However, its use is limited, due to associated skull base bonny and air artifact. MR-vessel wall imaging (VWI) is not limited by such artifact and therefore could be an alternative to QSM. The purpose of this study was to investigate the correlation between QSM and VWI in detecting MBs and to help develop a diagnostic strategy for SH. Methods: We performed a prospective study of subjects with one or more unruptured IAs in our hospital. All subjects underwent evaluation using 3T-MRI for MR angiography (MRA), QSM, and pre-and post-contrast VWI of the IAs. Presence/absence of MBs detected by QSM was correlated with aneurysm wall enhancement (AWE) on VWI. Results: A total of 40 subjects harboring 51 unruptured IAs were enrolled in the study. MBs evident on the QSM sequence was detected in 12 (23.5%) IAs of 11 subjects. All these subjects had a history of severe headache suggestive of SH. AWE was detected in 22 (43.1%) IAs. Using positive QSM as a surrogate for MBs, the sensitivity, specificity, positive predictive value, and negative predictive value of AWE on VWI for detecting MBs were 91.7%, 71.8%, 50%, and 96.6%, respectively. Conclusions: Positive QSM findings strongly suggested the presence of MBs with SH, whereas, the lack of AWE on VWI can rule it out with a probability of 96.6%. If proven in a larger cohort, combining QSM and VWI could be an adjunctive tool to help diagnose SH, especially in cases with negative or non-diagnostic CT and lumbar puncture.

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Section: Discussionmentioning

confidence: 68%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Quantitative Susceptibility Mapping and Vessel Wall Imaging as Screening Tools to Detect Microbleed in Sentinel Headache

Ishii

Nakagawa

Zanaty

et al. 2020

JCM

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“…Texakalidis et al included six studies comprising 505 saccular aneurysms: 302 stable and 203 unstable (ruptured, growing, or symptomatic). 5 Aneurysms with wall enhancement had statistically significantly higher odds of instability (OR 20, 95% CI 6.4 to 62.1). Such relationship remained significant after excluding ruptured aneurysms (OR 10.9, 95% CI 1.66 to 72.62).…”

Section: Aneurysm Wall Enhancement As An Indicator Of Aneurysm Instabmentioning

confidence: 96%

“…There are promising observations in the characterization of aneurysm wall enhancement as a biomarker of aneurysm wall inflammation, aneurysm growth and rupture. 5 This review aims to summarize the current information about HR-VWI in cerebral aneurysm characterization and to reflect our experience.…”

Section: Introductionmentioning

confidence: 99%

Vessel wall imaging in intracranial aneurysms

Samaniego

Roa

Hasan

2019

J NeuroIntervent Surg

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High-resolution vessel wall imaging (HR-vwi) is becoming a useful tool in the characterization and identification of unstable unruptured brain aneurysms. However, it has not been validated for clinical use. The current evidence on HR-vwi techniques for characterization of brain aneurysms is described in this review. Specific imaging approaches such as aneurysm wall contrast enhancement, MRi-quantitative susceptibility mapping, and 7T MRi are described in detail.

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Paraclinoid Internal Carotid Artery Aneurysm: Unruptured Lateral Paraclinoid Aneurysm Showing Aneurysm Wall Enhancement on MRI Vessel Wall Imaging, Treated with Flow Diversion

Filioglo

Leker

Honig

et al. 2021

The Aneurysm Casebook

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Vessel Wall Imaging of Intracranial Aneurysms: Systematic Review and Meta-analysis

Cited by 74 publications

References 20 publications

Quantitative Susceptibility Mapping and Vessel Wall Imaging as Screening Tools to Detect Microbleed in Sentinel Headache

Quantitative Susceptibility Mapping and Vessel Wall Imaging as Screening Tools to Detect Microbleed in Sentinel Headache

Vessel wall imaging in intracranial aneurysms

Paraclinoid Internal Carotid Artery Aneurysm: Unruptured Lateral Paraclinoid Aneurysm Showing Aneurysm Wall Enhancement on MRI Vessel Wall Imaging, Treated with Flow Diversion

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