Relationships between aneurysmal wall enhancement and conventional risk factors in patients with intracranial aneurysm: A high-resolution MRI study

J Neuroradiol. 2019 Feb;46(1):25-28. doi: 10.1016/j.neurad.2018.09.007. Epub 2018 Oct 30.


Background and purpose: Aneurysmal wall enhancement (AWE) is thought to reflect wall inflammation and is a novel imaging biomarker for intracranial aneurysm (IA) risk evaluation. However, the relationship between AWE and other conventional risk factors (e.g., size) remains unclear. The aim of this study was to investigate the relationship between AWE and other risk factors.

Material and methods: Seventy-six consecutive patients from February 2016 to April 2017 with 88 unruptured IAs were reviewed. Patients and IAs were divided into with AWE and without AWE groups according to high-resolution magnetic resonance imaging (HRMRI) images. In addition to the patients' clinical characteristics, the features of the IAs (e.g., size and aspect ratio (AR)) were evaluated via computed tomography angiography. Multiple logistic regression analysis was used to identify the association between AWE and other risk factors. A receiver operating characteristic curve analysis was performed for the final model to obtain optimal thresholds.

Results: IAs with an irregular shape (OR 12.544) and a high AR (OR 32.891) were associated with AWE. The threshold value of the AR was 1.05.

Conclusions: AWE on contrast-enhanced HRMRI was correlated with IAs with an irregular shape and a high AR. AWE may be a marker of instability and even risk of rupture.

Keywords: Aneurysmal wall enhancement; Inflammation; Intracranial aneurysm; Magnetic resonance imaging.

MeSH terms

  • Computed Tomography Angiography
  • Contrast Media
  • Female
  • Humans
  • Intracranial Aneurysm / diagnostic imaging*
  • Magnetic Resonance Imaging / methods*
  • Male
  • Middle Aged
  • Risk Assessment
  • Risk Factors
  • Triiodobenzoic Acids


  • Contrast Media
  • Triiodobenzoic Acids
  • iodixanol