title: Does aneurysmal wall enhancement on vessel wall MRI help to distinguish stable from unstable intracranial aneurysms?
abstract: OBJECTIVE
  Arterial wall enhancement on vessel wall MRI was described in intracranial inflammatory arterial disease. We hypothesized that circumferential aneurysmal wall enhancement (CAWE) could be an indirect marker of aneurysmal wall inflammation and, therefore, would be more frequent in unstable (ruptured, symptomatic, or undergoing morphological modification) than in stable (incidental and nonevolving) intracranial aneurysms.
  
  
  METHODS
  We prospectively performed vessel wall MRI in patients with stable or unstable intracranial aneurysms. Two readers independently had to determine whether a CAWE was present.
  
  
  RESULTS
  We included 87 patients harboring 108 aneurysms. Interreader and intrareader agreement for CAWE was excellent (κ=0.85; 95% confidence interval, 0.75-0.95 and κ=0.90; 95% confidence interval, 0.83-0.98, respectively). A CAWE was significantly more frequently seen in unstable than in stable aneurysms (27/31, 87% versus 22/77, 28.5%, respectively; P<0.0001). Multivariate logistic regression, including CAWE, size, location, multiplicity of aneurysms, and daily aspirin intake, revealed that CAWE was the only independent factor associated with unstable status (odds ratio, 9.20; 95% confidence interval, 2.92-29.0; P=0.0002).
  
  
  CONCLUSIONS
  CAWE was more frequently observed in unstable intracranial aneurysms and may be used as a surrogate of inflammatory activity in the aneurysmal wall.
authors.affiliation: From the Departments of Radiology (M.E., C.R.-R., D.T., W.B.H., S.L., J.F.M., C.O., O.N.) and Neurosurgery (F.N.), Université Paris Descartes Sorbonne Paris Cité, INSERM S894, Centre Hospitalier Sainte-Anne, Paris, France; Department of Interventional Neuroradiology, University of Montreal, CHUM Notre-Dame Hospital, Montreal, Quebec, Canada (J.-C.G., J.R.); and the Departments of Medical Physics and Radiology (O.W., P.T.), University of Wisconsin, Madison. m.edjlali@ch-sainte-anne.fr.
authors.forename: Myriam
authors.initials: M
authors.lastname: Edjlali
authors.affiliation: From the Departments of Radiology (M.E., C.R.-R., D.T., W.B.H., S.L., J.F.M., C.O., O.N.) and Neurosurgery (F.N.), Université Paris Descartes Sorbonne Paris Cité, INSERM S894, Centre Hospitalier Sainte-Anne, Paris, France; Department of Interventional Neuroradiology, University of Montreal, CHUM Notre-Dame Hospital, Montreal, Quebec, Canada (J.-C.G., J.R.); and the Departments of Medical Physics and Radiology (O.W., P.T.), University of Wisconsin, Madison.
authors.forename: Jean-Christophe
authors.initials: JC
authors.lastname: Gentric
authors.affiliation: From the Departments of Radiology (M.E., C.R.-R., D.T., W.B.H., S.L., J.F.M., C.O., O.N.) and Neurosurgery (F.N.), Université Paris Descartes Sorbonne Paris Cité, INSERM S894, Centre Hospitalier Sainte-Anne, Paris, France; Department of Interventional Neuroradiology, University of Montreal, CHUM Notre-Dame Hospital, Montreal, Quebec, Canada (J.-C.G., J.R.); and the Departments of Medical Physics and Radiology (O.W., P.T.), University of Wisconsin, Madison.
authors.forename: Christine
authors.initials: C
authors.lastname: Régent-Rodriguez
authors.affiliation: From the Departments of Radiology (M.E., C.R.-R., D.T., W.B.H., S.L., J.F.M., C.O., O.N.) and Neurosurgery (F.N.), Université Paris Descartes Sorbonne Paris Cité, INSERM S894, Centre Hospitalier Sainte-Anne, Paris, France; Department of Interventional Neuroradiology, University of Montreal, CHUM Notre-Dame Hospital, Montreal, Quebec, Canada (J.-C.G., J.R.); and the Departments of Medical Physics and Radiology (O.W., P.T.), University of Wisconsin, Madison.
authors.forename: Denis
authors.initials: D
authors.lastname: Trystram
authors.affiliation: From the Departments of Radiology (M.E., C.R.-R., D.T., W.B.H., S.L., J.F.M., C.O., O.N.) and Neurosurgery (F.N.), Université Paris Descartes Sorbonne Paris Cité, INSERM S894, Centre Hospitalier Sainte-Anne, Paris, France; Department of Interventional Neuroradiology, University of Montreal, CHUM Notre-Dame Hospital, Montreal, Quebec, Canada (J.-C.G., J.R.); and the Departments of Medical Physics and Radiology (O.W., P.T.), University of Wisconsin, Madison.
authors.forename: Wajih Ben
authors.initials: WB
authors.lastname: Hassen
authors.affiliation: From the Departments of Radiology (M.E., C.R.-R., D.T., W.B.H., S.L., J.F.M., C.O., O.N.) and Neurosurgery (F.N.), Université Paris Descartes Sorbonne Paris Cité, INSERM S894, Centre Hospitalier Sainte-Anne, Paris, France; Department of Interventional Neuroradiology, University of Montreal, CHUM Notre-Dame Hospital, Montreal, Quebec, Canada (J.-C.G., J.R.); and the Departments of Medical Physics and Radiology (O.W., P.T.), University of Wisconsin, Madison.
authors.forename: Stéphanie
authors.initials: S
authors.lastname: Lion
authors.affiliation: From the Departments of Radiology (M.E., C.R.-R., D.T., W.B.H., S.L., J.F.M., C.O., O.N.) and Neurosurgery (F.N.), Université Paris Descartes Sorbonne Paris Cité, INSERM S894, Centre Hospitalier Sainte-Anne, Paris, France; Department of Interventional Neuroradiology, University of Montreal, CHUM Notre-Dame Hospital, Montreal, Quebec, Canada (J.-C.G., J.R.); and the Departments of Medical Physics and Radiology (O.W., P.T.), University of Wisconsin, Madison.
authors.forename: François
authors.initials: F
authors.lastname: Nataf
authors.affiliation: From the Departments of Radiology (M.E., C.R.-R., D.T., W.B.H., S.L., J.F.M., C.O., O.N.) and Neurosurgery (F.N.), Université Paris Descartes Sorbonne Paris Cité, INSERM S894, Centre Hospitalier Sainte-Anne, Paris, France; Department of Interventional Neuroradiology, University of Montreal, CHUM Notre-Dame Hospital, Montreal, Quebec, Canada (J.-C.G., J.R.); and the Departments of Medical Physics and Radiology (O.W., P.T.), University of Wisconsin, Madison.
authors.forename: Jean
authors.initials: J
authors.lastname: Raymond
authors.affiliation: From the Departments of Radiology (M.E., C.R.-R., D.T., W.B.H., S.L., J.F.M., C.O., O.N.) and Neurosurgery (F.N.), Université Paris Descartes Sorbonne Paris Cité, INSERM S894, Centre Hospitalier Sainte-Anne, Paris, France; Department of Interventional Neuroradiology, University of Montreal, CHUM Notre-Dame Hospital, Montreal, Quebec, Canada (J.-C.G., J.R.); and the Departments of Medical Physics and Radiology (O.W., P.T.), University of Wisconsin, Madison.
authors.forename: Oliver
authors.initials: O
authors.lastname: Wieben
authors.affiliation: From the Departments of Radiology (M.E., C.R.-R., D.T., W.B.H., S.L., J.F.M., C.O., O.N.) and Neurosurgery (F.N.), Université Paris Descartes Sorbonne Paris Cité, INSERM S894, Centre Hospitalier Sainte-Anne, Paris, France; Department of Interventional Neuroradiology, University of Montreal, CHUM Notre-Dame Hospital, Montreal, Quebec, Canada (J.-C.G., J.R.); and the Departments of Medical Physics and Radiology (O.W., P.T.), University of Wisconsin, Madison.
authors.forename: Patrick
authors.initials: P
authors.lastname: Turski
authors.affiliation: From the Departments of Radiology (M.E., C.R.-R., D.T., W.B.H., S.L., J.F.M., C.O., O.N.) and Neurosurgery (F.N.), Université Paris Descartes Sorbonne Paris Cité, INSERM S894, Centre Hospitalier Sainte-Anne, Paris, France; Department of Interventional Neuroradiology, University of Montreal, CHUM Notre-Dame Hospital, Montreal, Quebec, Canada (J.-C.G., J.R.); and the Departments of Medical Physics and Radiology (O.W., P.T.), University of Wisconsin, Madison.
authors.forename: Jean-Francois
authors.initials: JF
authors.lastname: Meder
authors.affiliation: From the Departments of Radiology (M.E., C.R.-R., D.T., W.B.H., S.L., J.F.M., C.O., O.N.) and Neurosurgery (F.N.), Université Paris Descartes Sorbonne Paris Cité, INSERM S894, Centre Hospitalier Sainte-Anne, Paris, France; Department of Interventional Neuroradiology, University of Montreal, CHUM Notre-Dame Hospital, Montreal, Quebec, Canada (J.-C.G., J.R.); and the Departments of Medical Physics and Radiology (O.W., P.T.), University of Wisconsin, Madison.
authors.forename: Catherine
authors.initials: C
authors.lastname: Oppenheim
authors.affiliation: From the Departments of Radiology (M.E., C.R.-R., D.T., W.B.H., S.L., J.F.M., C.O., O.N.) and Neurosurgery (F.N.), Université Paris Descartes Sorbonne Paris Cité, INSERM S894, Centre Hospitalier Sainte-Anne, Paris, France; Department of Interventional Neuroradiology, University of Montreal, CHUM Notre-Dame Hospital, Montreal, Quebec, Canada (J.-C.G., J.R.); and the Departments of Medical Physics and Radiology (O.W., P.T.), University of Wisconsin, Madison.
authors.forename: Olivier
authors.initials: O
authors.lastname: Naggara
mesh_terms: D005260:Female; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D007249:Inflammation / Q000473:pathology*; D002532:Intracranial Aneurysm / Q000473:pathology*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged
keywords: aneurysm; inflammation; magnetic resonance imaging