Morphological parameters related to ruptured aneurysm in the patient with multiple cerebral aneurysms (clinical investigation).
OBJECTIVE
We evaluated the rupture risk of multiple cerebral aneurysms in aspects of various morphological parameters, and determined which parameter can be a reliable predictor as one aneurysm ruptured, and the others did not.


METHODS
Between 2007 and 2012, three-dimensional (3D) angiographic images of 85 patients harboring multiple aneurysms (85 ruptured and 104 unruptured aneurysms) were used to assess the following morphological parameters: geometry of the aneurysm itself, e.g., maximal size, aspect ratio, bottleneck ratio, height/width ratio, undulation, and daughter sac; architecture of the aneurysm and surrounding vessels, e.g. aneurysmal angle, vessel angle, inflow angle, parent-daughter angle, and size ratio type I & II. Univariate analysis was applied to all parameters, and significant parameters were identified in multivariate analysis, yielding the cut-off point from receiver-operating characteristic (ROC) curve analysis.


RESULTS
On multivariate logistic regression, the aspect ratio [odds ratio (OR), 1.21; 95% confidence interval (CI), 1.05-1.41] and daughter sac (OR, 3.12; 95% CI, 1.05-9.27) were significant parameters in geometries of the aneurysm itself. The size ratio type I (OR, 1.14; 95% CI, 1.05-1.22) and parent-daughter angle (OR, 1.02; 95% CI, 1.00-1.04) were independent parameters in architecture of the aneurysm and surrounding vessels. From the ROC curve, the aspect ratio and size ratio type I had cut-off values of 1.3 and 1.8, respectively.


CONCLUSIONS
Several morphological parameters were investigated to predict a rupture in multiple cerebral aneurysms using 3D angiogram. The aspect ratio, size ratio type I, daughter sac, and parent-daughter angle were revealed as competent parameters.
Hong Jun
HJ
Jeon
Jae Whan
JW
Lee
So Yeon
SY
Kim
Keun Young
KY
Park
Seung Kon
SK
Huh
D000328:Adult; D000368:Aged; D017542:Aneurysm, Ruptured / Q000473:pathology*; D002533:Cerebral Angiography; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional; D002532:Intracranial Aneurysm / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D012307:Risk Factors
Aspect ratio,; Daughter sac,; Morphological parameters,; Multiple cerebral aneurysms,; Parent–daughter angle; Size ratio,