Size and location of ruptured and unruptured intracranial aneurysms measured by 3-dimensional rotational angiography.
OBJECTIVE
The aim of the study was to report about accurate size and location of a consecutive series of ruptured and unruptured aneurysms taking the complex 3-dimensional (3D) anatomy and parent vessel morphology into consideration by using the newly developed 3D rotational angiography (3D-RA).


METHODS
One hundred eighteen consecutive patients with 155 saccular intracranial aneurysms were included in the study and received 3D-RA reconstructions for measurement of maximal height and width of the aneurysmal sac. Statistical evaluation compared values for ruptured (n = 83) and unruptured (n = 72) aneurysms.


RESULTS
Mean height and width of unruptured aneurysms were 5.7 and 5.7 mm; of ruptured aneurysms, 6.7 and 6.1 mm (not significant, P = .7 for height and P = .9 for width). The majority of ruptured aneurysms, 81.9% and 59%, were smaller than 10 and 7 mm; likewise, 81.9% and 68.1% of unruptured aneurysms were smaller than 10 and 7 mm. The difference in frequency of small (<10/<7 mm) aneurysms between unruptured and ruptured aneurysms was not significant (P = 1.0 and .32, respectively). The majority (69.4%) of small ruptured aneurysms (<7 mm) were located in the anterior circulation. Most ruptured aneurysms were in the size group 4 to 6 mm in height and 2 to 4 mm in width, and a critical threshold size for aneurysm rupture could not be identified.


CONCLUSIONS
An automated calibration procedure applied to all images and excellent visualization of aneurysm and parent vessel morphology using 3D-RA allow accurate size measurement of intracranial aneurysms which may be smaller than previously thought. Small aneurysm (<7 mm), also in the anterior circulation, should be carefully evaluated for treatment.
Beck
Jürgen
J
Department of Neurosurgery, Johann Wolfgang Goethe-University, 60528 Frankfurt am Main, Germany. j.beck@em.uni-frankfurt.de
Rohde
Stefan
S
Berkefeld
Joachim
J
Seifert
Volker
V
Raabe
Andreas
A
D017542:Aneurysm, Ruptured / Q000000981:diagnostic imaging* / Q000473:pathology; D002138:Calibration; D002533:Cerebral Angiography / Q000295:instrumentation / Q000379:methods*; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional / Q000295:instrumentation / Q000379:methods*; D002532:Intracranial Aneurysm / Q000000981:diagnostic imaging* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D013345:Subarachnoid Hemorrhage / Q000000981:diagnostic imaging / Q000473:pathology