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Measurement of Pulse Propagation Velocity, Distensibility and Strain in an Abdominal Aortic Aneurysm Mouse Model

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3D aneurysm wall enhancement is associated with symptomatic presentation.

Ashrita Raghuram¹, Sebastian Sanchez¹, Linder Wendt²

¹Department of Neurology, The University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA.

Journal of Neurointerventional Surgery

|July 19, 2022

Summary

A new 3D-aneurysm wall enhancement (AWE) mapping tool quantifies AWE, improving the identification of symptomatic aneurysms. This quantitative analysis offers a potential biomarker for aneurysm instability and clinical risk stratification.

Keywords:

Aneurysm MRI Stroke Technology Vessel Wall

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Area of Science:

Neuroimaging
Vascular Neurology
Biomarker Discovery

Background:

Aneurysm wall enhancement (AWE) is a potential biomarker for aneurysm instability.
Previous qualitative 2D assessments of AWE limit its clinical utility.

Purpose of the Study:

To develop and apply a novel quantitative 3D-AWE mapping tool for analyzing saccular aneurysms.
To assess the association between quantitative AWE metrics and symptomatic aneurysm presentation.

Main Methods:

Prospective 3T high-resolution MRI of saccular aneurysms.
Creation of 3D-AWE maps using orthogonal probes.
Quantification of 3D circumferential AWE (3D-CAWE), aneurysm-specific contrast uptake (SAWE), and focal AWE (FAWE).
Comparison of AWE metrics with clinical presentation, aneurysm characteristics, and imaging findings like blebs and microhemorrhage.

Main Results:

3D-AWE metrics (3D-CAWE, SAWE, FAWE) were significantly associated with symptomatic status.
A multivariate model incorporating aneurysm size, 3D-CAWE+, age, gender, and FAWE achieved high accuracy (AUC=0.967) in detecting symptomatic aneurysms.
FAWE correlated with irregular morphology and high-risk locations.
Enhanced contrast uptake in blebs and co-localization of microhemorrhage with SAWE were observed.

Conclusions:

3D-AWE mapping offers a novel quantitative approach to aneurysm assessment.
These new metrics show potential for improving the identification of symptomatic aneurysms and risk stratification.