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Fluorescence Angiography for Evaluation of Aneurysm Perfusion and Parent Artery Patency in Rat and Rabbit Aneurysm Models
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Identifying the Symptomatic Aneurysm in Patients With Multiple Intracranial Aneurysms
Andres Gudino1, Carlos Dier1, Sebastian Sanchez2
1Department of Neurology, University of Iowa, Iowa City, Iowa, USA.
Neurosurgery
|February 5, 2026
Summary
Identifying symptomatic aneurysms in patients with multiple intracranial aneurysms (MIAs) is challenging. Three-dimensional circumferential aneurysm wall enhancement (3D-CAWE) effectively identifies symptomatic aneurysms, offering a potential imaging biomarker.
Area of Science:
- Neurosurgery
- Radiology
- Medical Imaging
Background:
- Identifying symptomatic intracranial aneurysms among multiple aneurysms (MIAs) poses a clinical challenge.
- Aneurysm wall enhancement is a promising imaging biomarker for assessing aneurysm status.
Purpose of the Study:
- To evaluate the utility of three-dimensional circumferential aneurysm wall enhancement (3D-CAWE) in distinguishing symptomatic from asymptomatic aneurysms in patients with MIAs.
Main Methods:
- Retrospective analysis of high-resolution 3 Tesla MRI data from 30 patients with 82 MIAs across three institutions.
- Assessment of 3D-CAWE and morphological measurements.
- Multivariate logistic regression and ROC analysis to identify predictors of symptomatic status.
Main Results:
- Symptomatic aneurysms (36.6%) showed significantly higher 3D-CAWE compared to asymptomatic ones (P=.01).
- Aneurysm size and size ratio were not associated with symptomatic presentation.
- A 3D-CAWE cutoff of 1.02 demonstrated 88% specificity and 79% negative predictive value for symptomatic aneurysms.
Conclusions:
- Three-dimensional circumferential aneurysm wall enhancement (3D-CAWE) is a valuable tool for identifying symptomatic aneurysms in patients with multiple intracranial aneurysms.
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