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Research ArticleNeurointervention
Open Access

Wall Enhancement of Coiled Intracranial Aneurysms is Associated with Aneurysm Recanalization: A Cross-Sectional Study

Stefan L. Leber, Eva M. Hassler, Manuela Michenthaler, Wilfried Renner, Hannes Deutschmann and Gernot Reishofer
American Journal of Neuroradiology March 2024, DOI: https://doi.org/10.3174/ajnr.A8174
Stefan L. Leber
aFrom the Division of Neuroradiology, Vascular and Interventional Radiology (S.L.L., E.M.H., M.M., H.D., G.R.), Department of Radiology, Medical University of Graz, Graz, Austria
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  • ORCID record for Stefan L. Leber
Eva M. Hassler
aFrom the Division of Neuroradiology, Vascular and Interventional Radiology (S.L.L., E.M.H., M.M., H.D., G.R.), Department of Radiology, Medical University of Graz, Graz, Austria
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Manuela Michenthaler
aFrom the Division of Neuroradiology, Vascular and Interventional Radiology (S.L.L., E.M.H., M.M., H.D., G.R.), Department of Radiology, Medical University of Graz, Graz, Austria
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Wilfried Renner
bClinical Institute of Medical and Chemical Laboratory Diagnostics (W.R.), Medical University of Graz, Graz, Austria
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Hannes Deutschmann
aFrom the Division of Neuroradiology, Vascular and Interventional Radiology (S.L.L., E.M.H., M.M., H.D., G.R.), Department of Radiology, Medical University of Graz, Graz, Austria
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Gernot Reishofer
aFrom the Division of Neuroradiology, Vascular and Interventional Radiology (S.L.L., E.M.H., M.M., H.D., G.R.), Department of Radiology, Medical University of Graz, Graz, Austria
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  • FIG 1.
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    FIG 1.

    Flow chart displaying patient recruitment, exclusion criteria, and final study cohort.

  • FIG 2.
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    FIG 2.

    Examples of different enhancement patterns (AWE and ACE) of coiled intracranial aneurysms. A–D, MR imaging black-blood TSE images of coiled aneurysms (white arrows) precontrast with corresponding postcontrast images in the right lower corner. E, MRA of the aneurysm corresponding to C and F shows MRA of the aneurysm corresponding to D (white arrows). A, No enhancement in a coiled communicating anterior aneurysm. B, Rim artifacts in a treated communicating anterior aneurysm. C, ACE and AWE in a coiled left ICA aneurysm. D, Rim artifacts and ACE in a coiled basilar tip aneurysm. E, AWE and ACE are not necessarily at the same location as aneurysm recanalization. F, Aneurysm recanalization and ACE rather occur next to each other than at the same location in the aneurysm cavity.

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    FIG 3.

    The incidence of AWE and ACE as percentages compared between groups of different recanalization sizes. A, AWE was significantly more frequent in aneurysms with recanalization of 4–5 mm and >6 mm but not in aneurysms with recanalization of 1–3 mm. B, ACE appeared more frequently in larger aneurysm recanalization without statistical significance (1–3 mm; 4–5 mm; ≥ 6 mm). Double asterisks indicate a P-value of .01 or lower.

Tables

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    Table 1:

    Patient and aneurysm characteristics of our study cohort

    Recanalization (n= 38)No Recanalization (n= 22)P Value
    Age (mean)54.0 (SD, 12.9) yr55.9 (SD, 11.4) yr.583
    Female31 (81.6%)17 (77.3%).688
    aSAH14 (23.7%)13 (59.1%).095
    Anterior circulation29 (76.3%)17 (77.3%).933
    Posterior circulation9 (13.2%)5 (22.7%).933
    AWE21 (55.3%)6 (27.3%).036
    ACE22 (59.5%)12 (54.5%).712
    Mean InitMaxDM7.65 mm (SD, 2.81) mm6.76 mm (SD, 2.51) mm.2310
    Mean CurrMaxDM9.55 mm (SD, 3.58) mm7.19 mm (SD, 2.46) mm.005
    Mean DiffMaxDM1.89 mm (SD, 1.71) mm0.45 mm (SD, 0.67) mm.00004
    Mean RecaMaxDM3.71 mm (SD, 2.16) mm0n.d.
    • Note:—InitMaxDM indicates initial maximum diameter of aneurysm; CurrMaxDM, current maximum diameter of aneurysm; DiffMaxDM, difference of initial and current maximum diameters of aneurysm; RecaMaxDM, maximum diameter of aneurysm recanalization; aSAH, aneurysmal subarrachnoid haemorrhage; n.d., not determined.

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    Table 2:

    Parameters of independent variables of the multivariate regression analysis with the maximum recanalization diameter as a dependent variable

    BβTStandard ErrorCI (95%)P Value
    Age0.0210.1090.9970.022–0.022–0.065.324
    AWE1.5650.3172.6680.5860.386–2.743.01
    ACE–0.088–0.018–0.1510.581–1.257–1.081.881
    aSAH–0.363–0.074–0.6660.545–1.458–0.732.509
    Sex1.1670.1951.8750.622–0.085–2.418.067
    Circulation1.0240.1761.6990.603–0.188–2.235.096
    DiffMaxDM0.7930.5174.7430.1670.457–1.129<.001
    • Note:—DiffMaxDM indicates difference between initial maximum aneurysm diameter and current maximum diameter; B, regression coefficient; T, t-value; aSAH, aneurysmal subarrachnoid haemorrhage.

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Cite this article
Stefan L. Leber, Eva M. Hassler, Manuela Michenthaler, Wilfried Renner, Hannes Deutschmann, Gernot Reishofer
Wall Enhancement of Coiled Intracranial Aneurysms is Associated with Aneurysm Recanalization: A Cross-Sectional Study
American Journal of Neuroradiology Mar 2024, DOI: 10.3174/ajnr.A8174

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Wall Enhancement of Coiled Intracranial Aneurysms is Associated with Aneurysm Recanalization: A Cross-Sectional Study
Stefan L. Leber, Eva M. Hassler, Manuela Michenthaler, Wilfried Renner, Hannes Deutschmann, Gernot Reishofer
American Journal of Neuroradiology Mar 2024, DOI: 10.3174/ajnr.A8174
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