Assessment of the Risk of Rupture of Intracranial Aneurysms using Three-Dimensional Cerebral Digital Subtraction Angiography

Abstract

The aim of this study was to develop an improved binary logistic regression model for predicting the risk of intracranial aneurysm rupture. A cohort of patients (n=37) with aneurysms underwent three-dimensional digital subtraction angiography examination to measure several morphological parameters of the aneurysm. The aspect ratio (height/neck size) and the size ratio (length/mean diameter of parent vessel) were also calculated. All the morphological parameters combined with the aneurysm location and the patient's baseline data were used to derive a backward binary logistic regression model. In order to validate the model, it was applied to another independent cohort of 19 patients with aneurysms. The model had sensitivity, specificity and accuracy of 84.6%, 66.7% and 78.9%, respectively. This binary logistic regression model of aneurysm rupture risk identified the status of an aneurysm with high accuracy and could form the basis of more complex models in the future.

Morphological characteristics associated with the rupture risk of mirror posterior communicating artery aneurysms

“…However, a previous study reported that IA size does not shrink after rupture,17 and another study showed that parent vessel vasospasm occurred approximately 5 days following rupture 18. Another limitation is that this study only considered PComAAs, and the results may not be applicable to other sites of IAs.…”

Risk Factors for the Rupture of Middle Cerebral Artery Bifurcation Aneurysms Using CT Angiography

“…Many previous studies reported that a larger SR was associated with aneurysm rupture [17,31–34]. Lin et al reported that SR is associated with anterior communicating artery aneurysm rupture [33] but not with MCAAs [16], but these results also showed different risk factors for different locations.…”

“…We found that MD was an independent predictor of rupture status in bifurcation-type MCAAs, indicating that a smaller artery is associated with a higher risk of rupture. The aneurysm arising from a small artery has a thinner wall and would experience greater wall tension [31,34]. …”

Suggested Connections Between Risk Factors of Intracranial Aneurysms: A Review

“…A logistic regression model using aneurysm height, width and neck size identified aneurysm rupture status with good accuracy (83% sensitivity and 80% accuracy) 101 . A binary logistic regression model using aspect ratio and size ratio showed good sensitivity (approximately 84%) and specificity (about 66%) 154 . Logistic regression was used to evaluate the independent predictive value of maximum size and size ratio, only size ratio remained in the final predictive model 105 .…”