The Relationship of Morphological-Hemodynamic Characteristics, Inflammation, and Remodeling of Aneurysm Wall in Unruptured Intracranial Aneurysms

Li, Qingyuan; Zhang, Yisen; Yang, Junhua; Yang, Yi; Li, Maogui; Chen, Shanwen; Jiang, Pengjun; Wang, Nuochuan; Zhang, Yanan; Liu, Jia; Wu, Jun; Wang, Shuo

doi:10.1007/s12975-021-00917-1

Cited by 32 publications

(26 citation statements)

References 31 publications

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“…Low WSS has also been associated with the thin region of the IA wall in some studies ( 33 , 34 ). However, several studies found that thick aneurysm walls with inflammatory cell infiltration and atherosclerosis were negatively correlated with WSS and positively correlated with RRT ( 7 , 27 , 35 ). For instance, Meng et al postulated that high and low WSS might drive intracranial aneurysm growth and rupture through different pathological mechanisms, with low WSS facilitating inflammatory cell infiltration ( 36 ).…”

Section: Discussionmentioning

confidence: 99%

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Hemodynamic Characteristic Analysis of Aneurysm Wall Enhancement in Unruptured Middle Cerebral Artery Aneurysm

Zhong

Kuang

et al. 2022

Front. Neurol.

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Background and PurposeAneurysm wall enhancement (AWE) on vessel wall magnetic resonance imaging has been suggested as a marker of the unstable status of intracranial aneurysm (IA) and may predict IA rupture risk. However, the role of abnormal hemodynamics in unruptured IAs with AWE remains poorly understood. This study aimed to determine the association between abnormal hemodynamics and AWE in unruptured middle cerebral artery (MCA) aneurysms.MethodsA total of 28 patients with 32 bifurcation aneurysms of the middle cerebral artery>3mm in size were retrospectively selected for this study. Vessel wall magnetic resonance images were reviewed, and the AWE pattern of each aneurysm was classified as no AWE, partial AWE, and circumferential AWE. Computational fluid dynamics were used to calculate the hemodynamic variables of each aneurysm. Univariate and multivariate analyses investigated the association between AWE and hemodynamic variables.ResultsAWE was present in 13 aneurysms (40.6%), with 7 (21.9%) showing partial AWE and 6 (18.7%) showing circumferential AWE. Kruskal–Wallis H analysis revealed that hemodynamic variables including wall shear stress (WSS), oscillatory shear index, aneurysm pressure (AP), relative residence time, and low shear area (LSA) were significantly associated with AWE (p < 0.05). Further ordinal logistic regression analysis found that WSS was the only factor with a significant association with AWE (p = 0.048); similar trends were identified for LSA (p = 0.055) and AP (p = 0.058). Spearman's correlation analysis showed that AWE was negatively correlated with WSS (rs = −0.622, p < 0.001) and AP (rs = −0.535, p = 0.002) but positively correlated with LSA (rs = 0.774, p < 0.001).ConclusionLow wall shear stress, low aneurysm pressure, and increased low shear area were associated with aneurysm wall enhancement on vessel wall magnetic resonance imaging in unruptured cerebral aneurysms. These abnormal hemodynamic parameters may induce inflammation and cause aneurysm wall enhancement. However, the association between these parameters and their underlying pathological mechanisms requires further investigation.

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Section: Discussionmentioning

confidence: 99%

“…Inflammation is an important factor for aneurysm remodeling and results in aneurysm growth and rupture ( 7 ). Recently, aneurysm wall enhancement (AWE) on vessel wall magnetic resonance imaging (MRI) has been suggested as an indirect marker of aneurysm wall inflammation ( 8 – 10 ).…”

Section: Introductionmentioning

confidence: 99%

Hemodynamic Characteristic Analysis of Aneurysm Wall Enhancement in Unruptured Middle Cerebral Artery Aneurysm

Zhong

Kuang

et al. 2022

Front. Neurol.

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“…Based on the H-E staining and by referencing previous studies (17,18), three random sections were classified for aneurysm wall types by two investigators (JW and PL) blinded to clinical information. To be specific, the sections were (1) type I, described as endothelialized wall with organized smooth muscle cells, (2) type II&III, defined as a thickened wall with disorganized smooth muscle cells or hypocellular wall with intimal hyperplasia or luminal thrombosis, as well as (3) type IV, i.e., an extremely thin thrombosis-lined hypocellular wall.…”

Section: Serum Cytokines Detection and Histological Analysismentioning

confidence: 99%

“…The severest remodeling type in three random sections was taken for further analysis. We defined the type II&III and type IV aneurysm wall as AWR wall (17). The atherosclerosis area was measured based on the Masson staining according to our previous study (17).…”

Section: Serum Cytokines Detection and Histological Analysismentioning

confidence: 99%

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Serum IL-1, Pyroptosis and Intracranial Aneurysm Wall Enhancement: Analysis Integrating Radiology, Serum Cytokines and Histology

Zhang

Zhu

et al. 2022

Front. Cardiovasc. Med.

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Background and PurposeAneurysm wall enhancement (AWE) is correlated with the rupture and growth risk of unruptured intracranial aneurysms (UIAs). Pyroptosis is a proinflammation mode of lytic cell death, mediated by pyroptosis-related proteins, i.e., gasdermin D and interleukin 1 β (IL-1β). Integrating serum cytokines and histology, this study aimed to investigate the correlation between AWE and pyroptosis in UIAs.MethodsUIA patients receiving microsurgical clipping were prospectively enrolled from January 2017 and June 2020. UIA samples were collected, as well as the corresponding blood samples. In this study, high-resolution magnetic resonance was employed to identify the AWE. The serum 46-cytokines examination and the histological analysis were conducted to determine pyroptosis, CD68 and MMP2. The IL-1 ra/beta ratio was determined by complying with the serum IL-1β and IL-1.ra. A comparison was drawn in the differences between UIAs with and without AWE. Lastly, the correlation between inflammation in UIA samples and serums was investigated.ResultsThis study included 34 UIA patients. The serum proinflammatory cytokines [IL-1β (P < 0.001) and TNF-α (P < 0.001)] were up-regulated, and serum anti-inflammatory cytokine (IL-1.ra, P = 0.042) were down-regulated in patients with AWE UIAs. The patients with AWE UIAs achieved a higher IL-1.ra/beta ratio (P < 0.001). The multivariate logistic analysis demonstrated IL-1β [odds ratio (OR), 1.15; 95% confidence interval (CI), 1.02–1.30; P = 0.028] and IL-1.ra (OR, 0.998; 95% CI, 0.997–1.000; P = 0.017) as the risk factors correlated with the AWE. IL-1.ra/beta ratio achieved the highest predictive accuracy [area under the curve (AUC), 0.96] for AWE, followed by IL-1.ra (AUC, 0.90), IL-1β (AUC, 0.88) and TNF-α (AUC, 0.85). As compared with the UIAs without AWE, the AWE UIAs were manifested as a severer wall remodeling, with higher relative levels of pyroptosis-related proteins, CD68 and MMP2. The serum IL-1β, IL-1.ra and IL-1.ra/beta ratio had a positive correlation with the relative levels of pyroptosis-related proteins, CD68 and MMP2 in UIA tissues.ConclusionThe serum IL-1β and IL-1.ra were correlated with the AWE. More pyroptosis-related proteins were identified in UIAs with AWE. The serum IL-1β and IL-1.ra were correlated with the pyroptosis-related proteins in aneurysm tissues.

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A deep learning framework for intracranial aneurysms automatic segmentation and detection on magnetic resonance T1 images

Qu,

Niu,

et al. 2023

Eur Radiol

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The Relationship of Morphological-Hemodynamic Characteristics, Inflammation, and Remodeling of Aneurysm Wall in Unruptured Intracranial Aneurysms

Cited by 32 publications

References 31 publications

Hemodynamic Characteristic Analysis of Aneurysm Wall Enhancement in Unruptured Middle Cerebral Artery Aneurysm

Hemodynamic Characteristic Analysis of Aneurysm Wall Enhancement in Unruptured Middle Cerebral Artery Aneurysm

Serum IL-1, Pyroptosis and Intracranial Aneurysm Wall Enhancement: Analysis Integrating Radiology, Serum Cytokines and Histology

A deep learning framework for intracranial aneurysms automatic segmentation and detection on magnetic resonance T1 images

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