Analysis of the Risk of Basilar Aneurysm Rupture Based on CTA Morphological Parameters
Download PDF

Keywords

Basilar origin aneurysm
Rupture
Tomography
Computed tomography
Risk factors

DOI

10.26689/jcnr.v7i5.5197

Submitted : 2023-08-23
Accepted : 2023-09-07
Published : 2023-09-22

Abstract

Objective: To investigate morphological risk factors of basilar aneurysm rupture based on computer tomography angiography (CTA) parameters. Materials and methods: The clinical and CTA data of 43 patients with basilar aneurysm admitted to Shaanxi Provincial People’s Hospital from January 2015 to July 2023 were analyzed. The patients were divided into “ruptured group” and “unruptured group,” and the morphological parameters of aneurysms were measured. The general data and morphological parameters between the two groups were statistically analyzed. Logistic regression was used to analyzed statistically significant parameters, and the receiver operating characteristic curve was drawn to evaluate its diagnostic effectiveness. Results: Irregular aneurysms were more likely to rupture than regular aneurysms (x² = 13.971, P < 0.05). The maximum diameter (4.92 [3.37–6.94] mm), length-width ratio (1.31 [1.14–1.55]), height (4.08 [2.71–5.34] mm), aspect ratio (0.99 [0.84–1.45]), and inflow angle (133.63 ± 11.21°) of aneurysms in the ruptured group were larger than the unruptured group, and the differences were statistically significant (P < 0.05). Binary logistic regression showed
that aneurysm shape (OR = 39.347, P = 0.021), length-width ratio (OR = 313.062, P = 0.033), and inflow angle (OR = 1.156, P = 0.004) were independent risk factors for rupture. The area under the curve were 0.809, 0.842. and 0.894, respectively. Conclusion: Aneurysm shape, aspect ratio, and blood flow incidence angle are independent risk factors for basilar aneurysm rupture, which means that they can be used to predict the risk of rupture to a certain extent.

References

Tawk RG, Hasan TF, D’Souza CE, et al. 2021, Diagnosis and Treatment of Unruptured Intracranial Aneurysms and Aneurysmal Subarachnoid Hemorrhage. Mayo Clin Proc, 96(7): 1970–2000.

Qi P, Feng X, Lu J, et al. 2021, Morphological Irregularity of Unruptured Intracranial Aneurysms is More Related with Aneurysm Size Rather than Cerebrovascular Atherosclerosis: A Case-Control Study. Clin Interv Aging, 16: 665–674.

Park GT, Kim JH, Jung YJ, et al. 2021, Characteristics of Patients with Ruptured Very Small Intracranial Aneurysm Sized Less Than 3 mm. J Cerebrovasc Endovasc Neurosurg, 23(1): 1–5.

Fotakopoulos G, Andrade-Barazarte H, Tjahjadi M, et al. 2021, Clipping Versus Coiling in Ruptured Basilar Apex Aneurysms: A Meta-Analysis. Turk Neurosurg, 31(3): 301–309.

Zheng Y, Zhou B, Wang X, et al. 2019, Size, Aspect Ratio and Anatomic Location of Ruptured Intracranial Aneurysms: Consecutive Series Of 415 Patients from a Prospective, Multicenter, Observational Study. Cell Transplant, 28(6): 739–746.

Fung C, Mavrakis E, Filis A, et al. 2019, Anatomical Evaluation of Intracranial Aneurysm Rupture Risk in Patients with Multiple Aneurysms. Neurosurg Rev, 42(2): 539–547.

Zhong W, Su W, Li T, et al. 2021, Aneurysm Wall Enhancement in Unruptured Intracranial Aneurysms: A Histopathological Evaluation. J Am Heart Assoc, 10(2): e018633.

Sim SY, Chung J, Choi JH, et al., 2022, Basilar Artery Trunk Aneurysm: Clinical and Angiographic Outcomes of Endovascular Treatment. J Neurointerv Surg, 14(3): 262–267.

Narsinh KH, Caton MT, Mahmood NF, et al. 2021, Intrasaccular Flow Disruption (WEB) of a Large Wide-Necked Basilar Apex Aneurysm Using PulseRider-Assistance. Interdiscip Neurosurg, 24: 101072.

Dhar S, Tremmel M, Mocco J, et al., 2008, Morphology Parameters for Intracranial Aneurysm Rupture Risk Assessment. Neurosurgery, 63(2): 185–197.

Skodvin TØ, Evju Ø, Sorteberg A, et al., 2019, Prerupture Intracranial Aneurysm Morphology in Predicting Risk of Rupture: A Matched Case-Control Study. Neurosurgery, 84(1): 132–140.

Gu Y, Zhang Y, Luo M, et al., 2019, Dynamic Volume Change Rate and Aspect Ratio are Correlated to the Formation of an Irregular Morphology of Unruptured Intracranial Aneurysm. J Comput Assist Tomogr, 43(2): 294–299.

Al-Sharydah A, Al-Abdulwahhab A, Al-Suhibani S, et al. 2021, The Analysis of Morphoradiological Parameters in Predicting Risk of Basilar Artery Tip Aneurysm Rupture: A Retrospective Cohort Study. Int J Gen Med, 14: 3335–3342.

Skodvin TØ, Johnsen LH, Gjertsen Ø, et al., 2017, Cerebral Aneurysm Morphology Before and After Rupture: Nationwide Case Series of 29 Aneurysms. Stroke, 48(4): 880–886.

Zhang J, Can A, Lai PMR, et al., 2021, Morphological Variables Associated with Ruptured Basilar Tip Aneurysms. Sci Rep, 11(1): 2526.

Lauric A, Miller EL, Baharoglu MI, et al., 2011, 3D Shape Analysis of Intracranial Aneurysms Using the Writhe Number as a Discriminant for Rupture. Ann Biomed Eng, 39(5): 1457–1469.

Juchler N, Schilling S, Bijlenga P, et al., 2020, Shape Irregularity of the Intracranial Aneurysm Lumen Exhibits Diagnostic Value. Acta Neurochir (Wien), 162(9): 2261–2270.