Aneurysm Wall Contrast on Magnetic Resonance Imaging: A New Predictor of Rupture of Saccular Intracranial Aneurysms

Background. Recent studies suggest that accumulation of contrast agent in the aneurysm’s wall may predict a high risk of aneurysm growth or rupture.

Objective. To compare the enhancement of the aneurysm wall with other characteristics that affect at the risk of rupture.

Materials and Methods. The study included 95 patients with 132 previously identified saccular aneurysms, who underwent magnetic resonance imaging (MRI) according to a specialized protocol using 3.0 Tesla MRI scanner. The presence or absence of aneurysm’s wall enhancement compared with the following characteristics: gender and age of the patient, the size and shape of the aneurysm, the presence of arterial hypertension, and the PHASES score.

Results. Accumulation of contrast agent by the aneurysm’s wall was associated with the aneurysm dome size (p < 0,001, Sp = 78,1 %, Se = 72,1 %) and PHASES score (p < 0,001, Sp = 64,1 %, Se =57,1 %). No relationship between age, gender, arterial hypertension, shape, and aneurysm location and contrast enhancement was found (p > 0,05).

Conclusion. Contrast enhancement of the aneurysm wall on MRI can be considered an additional risk marker of its rupture.

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