Gadolinium-Enhanced Aneurysm Wall Imaging and Risk of Intracranial Aneurysm Growth or Rupture

作者：Qingyuan Liu, Xin Nie, Mervyn D. I. Vergouwen, Yuting Wang, Hongwei He, Jun Wu, Yi Yang, Shaohua Mo, Lei Chen, Mahmud Mossa‐Basha, Michael R. Levitt, Myriam Edjlali, Jiangan Li, Jinrui Ren, Bing Zhao, Shuo Wang, Peng Liu, Chengcheng Zhu · 发表于：JAMA Neurology · 年份：2025 · DOI：10.1001/jamaneurol.2025.3209 · 被引用次数：12 · 研究领域：Intracranial Aneurysms: Treatment and Complications、Meningioma and schwannoma management、Vascular Malformations Diagnosis and Treatment

Importance: Recent longitudinal studies in patients with unruptured intracranial aneurysms (UIAs) suggested that aneurysm wall enhancement (AWE) on magnetic resonance imaging (MRI) predicts growth and rupture. However, because these studies were limited by small sample size and short follow-up duration, it remains unclear whether this radiological biomarker has predictive value for UIA instability. Objective: To determine the 4-year risk of instability of UIAs with AWE and investigate whether AWE is an independent predictor of UIA instability. Design, Setting, and Participants: Individual patient data were obtained from 3 prospective multicenter cohort studies conducted in 83 Chinese centers between January 2017 and December 2024. Included were patients aged 18 to 75 years with at least 1 asymptomatic, saccular UIA greater than or equal to 3 mm. Exposures: All patients had 3-T MRI gadolinium-enhanced aneurysm wall imaging and computed tomography angiography (CTA) at baseline, and CTA at follow-up. Main Outcomes and Measures: The primary outcome measure was aneurysm growth or rupture (instability) during follow-up. The absolute risk of aneurysm instability in UIAs with circumferential, focal, and no AWE was determined with Kaplan-Meier estimates at 4 years after baseline aneurysm wall imaging. Cox proportional hazards regression was used to investigate AWE as a potential predictor of instability. Results: Of the 1453 patients who had baseline 3-T MRI aneurysm wall imaging, 41 ...