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

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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).

Patient characteristics

Patient	Age (yr)	Sex	ASA	Nicotine	Estimated 5-Year Rupture Risk (PHASES)	Size of Aneurysm (mm)	Location of Aneurysm	Multiple Aneurysms	Enhancement in VWI	MPO	CD34	Vasa Vasorum
1	48	Male	Yes	No	3.2%	17	Right MCA	No	Strong	+	+	No
2	64	Male	Yes	Yes	0.4%	6	Right MCA	No	Strong	+	+	No
3	73	Female	Yes	Yes	5.3%	10	Right MCA	No	Strong	+	+	No
4	48	Female	No	Yes	3.2%	10	Left MCA	No	Faint	−	−	No
5	52	Female	Yes	Yes	0.7%	5	Right MCA	Yes	None	−	−	No
6	53	Male	Yes	Yes	4.3%	14	Right MCA	No	Strong	−	−	Yes
7	53	Female	Yes	Yes	0.7%	7	Left MCA	No	None	−	−	No
8	46	Male	No	Yes	0.4%	6	Left MCA	Yes	Strong (partial)	+	−	Yes
9	48	Male	No	Yes	0.4%	8	Left MCA	No	None	−	−	No
10	57	Female	No	No	1.7%	9	Right MCA	No	None	−	−	No
11	67	Female	No	Yes	0.7%	4	Right MCA	No	None	−	−	No
12	36	Female	No	No	0.4%	4	Right MCA	No	None	−	−	No
13	49	Female	No	Yes	1.3%	9	Right MCA	No	None	−	−	No