title: Rupture-associated changes of cerebral aneurysm geometry: high-resolution 3D imaging before and after rupture.
abstract: OBJECTIVE
  Comparisons of geometric data of ruptured and unruptured aneurysms may yield risk factors for rupture. Data on changes of geometric measures associated with rupture are, however, sparse, because patients with ruptured aneurysms rarely have undergone previous imaging of the intracranial vasculature. We had the opportunity to assess 3D geometric differences of aneurysms before and after rupture. The purpose of this study was to evaluate possible differences between prerupture and postrupture imaging of a ruptured intracranial aneurysm.
  
  
  METHODS
  Using high-quality 3D image data, we generated 3D geometric models before and after rupture and compared these for changes in aneurysm volume and displacement. A neuroradiologist qualitatively assessed aneurysm shape change, the presence of perianeurysmal hematoma, and subsequent mass effect exerted on aneurysm and parent vessels.
  
  
  RESULTS
  Aneurysm volume was larger in the postrupture imaging in 7 of 9 aneurysms, with a median increase of 38% and an average increase of 137%. Three aneurysms had new lobulations on postrupture imaging; 2 other aneurysms were displaced up to 5 mm and had changed in geometry due to perianeurysmal hematoma.
  
  
  CONCLUSIONS
  Geometric comparisons of aneurysms before and after rupture show a large volume increase, origination of lobulations, and displacement due to perianeurysmal hematoma. Geometric and hemodynamic comparison of series of unruptured and ruptured aneurysms in the search for rupture-risk-related factors should be interpreted with caution.
authors.affiliation: From the Departments of Radiology (J.J.S., H.A.M., R.v.d.B., C.B.M.) j.j.schneiders@amc.uva.nl.
authors.forename: J J
authors.initials: JJ
authors.lastname: Schneiders
authors.affiliation: From the Departments of Radiology (J.J.S., H.A.M., R.v.d.B., C.B.M.)Biomedical Engineering and Physics (H.A.M., E.V.), Academic Medical Center, Amsterdam, the Netherlands.
authors.forename: H A
authors.initials: HA
authors.lastname: Marquering
authors.affiliation: From the Departments of Radiology (J.J.S., H.A.M., R.v.d.B., C.B.M.).
authors.forename: R
authors.initials: R
authors.lastname: van den Berg
authors.affiliation: Biomedical Engineering and Physics (H.A.M., E.V.), Academic Medical Center, Amsterdam, the Netherlands.
authors.forename: E
authors.initials: E
authors.lastname: VanBavel
authors.affiliation: Department of Radiology (B.V.), University Medical Center Utrecht, Utrecht, the Netherlands.
authors.forename: B
authors.initials: B
authors.lastname: Velthuis
authors.affiliation: Department of Neurology and Neurosurgery (G.J.E.R.), Brain Center Rudolf Magnus.
authors.forename: G J E
authors.initials: GJ
authors.lastname: Rinkel
authors.affiliation: From the Departments of Radiology (J.J.S., H.A.M., R.v.d.B., C.B.M.).
authors.forename: C B
authors.initials: CB
authors.lastname: Majoie
mesh_terms: D017542:Aneurysm, Ruptured / Q000473:pathology*; D002533:Cerebral Angiography / Q000379:methods; D002536:Cerebral Arteries / Q000473:pathology*; D003198:Computer Simulation; D006801:Humans; D007090:Image Interpretation, Computer-Assisted / Q000379:methods*; D021621:Imaging, Three-Dimensional / Q000379:methods*; D002532:Intracranial Aneurysm / Q000473:pathology*; D008953:Models, Anatomic; D008955:Models, Cardiovascular; D008959:Models, Neurological