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Research ArticleAdult Brain

Vessel Wall Enhancement in Unruptured Intracranial Aneurysms: An Indicator for Higher Risk of Rupture? High-Resolution MR Imaging and Correlated Histologic Findings

N. Larsen, C. von der Brelie, D. Trick, C.H. Riedel, T. Lindner, J. Madjidyar, O. Jansen, M. Synowitz and C. Flüh
American Journal of Neuroradiology September 2018, 39 (9) 1617-1621; DOI: https://doi.org/10.3174/ajnr.A5731
N. Larsen
aFrom the Department of Radiology and Neuroradiology (N.L., C.H.R., T.L., J.M., O.J.)
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C. von der Brelie
bDepartment of Neurosurgery (C.v.d.B., M.S., C.F.)
dDepartment of Neurosurgery (C.v.d.B.), University Hospital Göttingen, Göttingen, Germany.
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D. Trick
cInstitute of Pathology (D.T.), University Hospital Schleswig-Holstein Campus Kiel, Kiel, Germany
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C.H. Riedel
aFrom the Department of Radiology and Neuroradiology (N.L., C.H.R., T.L., J.M., O.J.)
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T. Lindner
aFrom the Department of Radiology and Neuroradiology (N.L., C.H.R., T.L., J.M., O.J.)
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J. Madjidyar
aFrom the Department of Radiology and Neuroradiology (N.L., C.H.R., T.L., J.M., O.J.)
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O. Jansen
aFrom the Department of Radiology and Neuroradiology (N.L., C.H.R., T.L., J.M., O.J.)
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M. Synowitz
bDepartment of Neurosurgery (C.v.d.B., M.S., C.F.)
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C. Flüh
bDepartment of Neurosurgery (C.v.d.B., M.S., C.F.)
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    Fig 1.

    Nonenhanced (left) and contrast-enhanced (right) MR vessel wall imaging shows circumferential strong contrast enhancement of a right middle cerebral artery aneurysm.

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    Fig 2.

    CD34 (A and C), hematoxylin-eosin (B and D), and MPO stain (E) at 10x magnification. A and B, Patient 3: aneurysm wall with evidence of neovascularization (arrows). C and D, Patient 8, vasa vasorum are present (arrowheads). There is no sign of neovascularization. E, The same patient as in C and D. MPO-positive aneurysm wall with accumulation of MPO-positive inflammatory cells in the tunica media (dotted arrows).

Tables

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  • Patient characteristics

    PatientAge (yr)SexASANicotineEstimated 5-Year Rupture Risk (PHASES)Size of Aneurysm (mm)Location of AneurysmMultiple AneurysmsEnhancement in VWIMPOCD34Vasa Vasorum
    148MaleYesNo3.2%17Right MCANoStrong++No
    264MaleYesYes0.4%6Right MCANoStrong++No
    373FemaleYesYes5.3%10Right MCANoStrong++No
    448FemaleNoYes3.2%10Left MCANoFaint−−No
    552FemaleYesYes0.7%5Right MCAYesNone−−No
    653MaleYesYes4.3%14Right MCANoStrong−−Yes
    753FemaleYesYes0.7%7Left MCANoNone−−No
    846MaleNoYes0.4%6Left MCAYesStrong (partial)+−Yes
    948MaleNoYes0.4%8Left MCANoNone−−No
    1057FemaleNoNo1.7%9Right MCANoNone−−No
    1167FemaleNoYes0.7%4Right MCANoNone−−No
    1236FemaleNoNo0.4%4Right MCANoNone−−No
    1349FemaleNoYes1.3%9Right MCANoNone−−No
    • Note:—ASA indicates acetylsalicylic acid; +, positive; −, negative.

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American Journal of Neuroradiology: 39 (9)
American Journal of Neuroradiology
Vol. 39, Issue 9
1 Sep 2018
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Vessel Wall Enhancement in Unruptured Intracranial Aneurysms: An Indicator for Higher Risk of Rupture? High-Resolution MR Imaging and Correlated Histologic Findings
N. Larsen, C. von der Brelie, D. Trick, C.H. Riedel, T. Lindner, J. Madjidyar, O. Jansen, M. Synowitz, C. Flüh
American Journal of Neuroradiology Sep 2018, 39 (9) 1617-1621; DOI: 10.3174/ajnr.A5731

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Vessel Wall Enhancement in Unruptured Intracranial Aneurysms: An Indicator for Higher Risk of Rupture? High-Resolution MR Imaging and Correlated Histologic Findings
N. Larsen, C. von der Brelie, D. Trick, C.H. Riedel, T. Lindner, J. Madjidyar, O. Jansen, M. Synowitz, C. Flüh
American Journal of Neuroradiology Sep 2018, 39 (9) 1617-1621; DOI: 10.3174/ajnr.A5731
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  • Vessel Wall Enhancement in Treated Unruptured Aneurysms
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