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Analysis of aneurysm rupture in relation to the geometric indices: aspect ratio, volume, and volume-to-neck ratio

  • Interventional Neuroradiology
  • Published:
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Abstract

Introduction

Geometric indices of cerebral aneurysms have been widely studied to determine rupture risk. However, most of these parameters were evaluated based on two-dimensional (2D) images and could have a measurement bias. We propose a new three-dimensional geometric index, an aneurysm volume-to-neck area ratio (VNR). To determine whether the VNR of ruptured aneurysms is different from that of unruptured aneurysms, we compared VNR with other 2D geometric indices in discriminative capacity for aneurysm rupture status.

Methods

Two hundred fourteen aneurysms in 195 patients (mean age, 57.44 ± 11.21 years; males, 69; females, 126) were retrospectively evaluated. There were 105 ruptured and 109 unruptured aneurysms. The five geometric indices [aspect ratio (AR), bottleneck ratio (BR), height-width ratio (HWR), volume, and VNR] were calculated from angiographic data and assessed to determine correlation with aneurysm rupture (t test). Receiver operating characteristic (ROC) curve analysis was used for comparison of discriminative capacity between different indices.

Results

AR, BR, HWR, and VNR were correlated with rupture status. Areas under the ROC curve of the aspect ratio and VNR were significantly larger than that of the HWR, BR, and volume. However, AR and VNR did not show a significant difference.

Conclusion

A larger aneurysm volume in proportion to the neck could be one of the geometric indices of aneurysms that indicate a higher rupture risk. This characteristic is represented by the aspect ratio.

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References

  1. Raghavan ML, Ma B, Harbaugh RE (2005) Quantified aneurysm shape and rupture risk. J Neurosurg 102:355–362

    Article  PubMed  Google Scholar 

  2. Ujiie H, Tamano Y, Sasaki K, Hori T (2001) Is the aspect ratio a reliable index for predicting the rupture of a saccular aneurysm? Neurosurgery 48:495–502

    Article  PubMed  CAS  Google Scholar 

  3. Nader-Sepahi A, Casimiro M, Sen J, Kitchen ND (2004) Is aspect ratio a reliable predictor of intracranial aneurysm rupture? Neurosurgery 54:1343–1347

    Article  PubMed  Google Scholar 

  4. Hoh BL, Sistrom CL, Firment CS, Fautheree GL, Velat GJ, Whiting JH, Reavey-Cantwell JF, Lewis SB (2007) Bottleneck factor and height–width ratio: association with ruptured aneurysms in patients with multiple cerebral aneurysms. Neurosurgery 61:716–722

    Article  PubMed  Google Scholar 

  5. Dhar S, Tremmel M, Mocco J, Kim M, Yamamoto J, Siddiqui AH, Hopkins LN, Meng H (2008) Morphology parameters for intracranial aneurysm rupture risk assessment. Neurosurgery 63:185–196. doi:10.1227/01.NEU.0000316847.64140.81

    Article  PubMed  Google Scholar 

  6. Sadatomo T, Yuki K, Migita K, Taniguchi E, Kodama Y, Kurisu K (2008) Morphological differences between ruptured and unruptured cases in middle cerebral artery aneurysms. Neurosurgery 62:602–609. doi:10.1227/01.NEU.0000311347.35583.0C

    Article  PubMed  Google Scholar 

  7. Ujiie H, Tachibana H, Hiramatsu O, Hazel AL, Matsumoto T, Ogasawara Y, Nakajima H, Hori T, Takakura K, Kajiya F (1999) Effects of size and shape (aspect ratio) on the hemodynamics of saccular aneurysms: a possible index for surgical treatment of intracranial aneurysms. Neurosurgery 45:119–129

    Article  PubMed  CAS  Google Scholar 

  8. Piotin M, Daghman B, Mounayer C, Spelle L, Moret J (2006) Ellipsoid approximation versus 3d rotational angiography in the volumetric assessment of intracranial aneurysms. AJNR Am J Neuroradiol 27:839–842

    PubMed  CAS  Google Scholar 

  9. Parlea L, Fahrig R, Holdsworth DW, Lownie SP (1999) An analysis of the geometry of saccular intracranial aneurysms. AJNR Am J Neuroradiol 20:1079–1089

    PubMed  CAS  Google Scholar 

  10. Yamura M, Hirai T, Korogi Y, Ikushima I, Yamashita Y (2005) Quantitative evaluation of measurement accuracy for three-dimensional angiography system using various phantoms. Radiat Med 23:175–181

    PubMed  Google Scholar 

  11. Byun HS, Rhee K (2003) Intraaneurysmal flow changes affected by clip location and occlusion magnitude in a lateral aneurysm model. Med Eng Phys 25:581–589

    Article  PubMed  Google Scholar 

  12. Fluss R, Faraggi D, Reiser B (2005) Estimation of the Youden Index and its associated cutoff point. Biom J 47:458–472

    Article  PubMed  Google Scholar 

  13. Ozdamar N, Celebi G (1978) Pressure distribution on the wall of experimental aneurysms. Acta Neurochir 45:27–34

    Article  CAS  Google Scholar 

  14. Kerber CW, Heilman CB (1983) Flow in experimental berry aneurysms: method and model. AJNR Am J Neuroradiol 4:374–377

    PubMed  CAS  Google Scholar 

  15. Tateshima S, Chien A, Sayre J, Cebral J, Vinuela F (2010) The effect of aneurysm geometry on the intra-aneurysmal flow condition. Neuroradiology. doi:10.1007/s00234-010-0687-4

    PubMed  Google Scholar 

  16. Beck J, Rohde S, El Beltagy M, Zimmermann M, Berkefeld J, Seifert V, Raabe A (2003) Difference in configuration of ruptured and unruptured intracranial aneurysms determined by biplanar digital subtraction angiography. Acta Neurochir 145:861–865. doi:10.1007/s00701-003-0124-0

    Article  CAS  Google Scholar 

  17. Weir B, Amidei C, Kongable G, Findlay JM, Kassell NF, Kelly J, Dai L, Karrison TG (2003) The aspect ratio (dome/neck) of ruptured and unruptured aneurysms. J Neurosurg 99:447–451

    Article  PubMed  Google Scholar 

  18. Ma B, Harbaugh RE, Raghavan ML (2004) Three-dimensional geometrical characterization of cerebral aneurysms. Ann Biomed Eng 32:264–273

    Article  PubMed  Google Scholar 

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Acknowledgment

This work was supported by the program of Kyung Hee University for the Young Researcher in Medical Science (KHU-2010719).

Conflict of interest statement

We declare that we have no conflict of interest.

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Authors and Affiliations

  1. Department of Radiology, Kyung Hee University Hospital at Gangdong, College of Medicine, Kyung Hee University, Sangil-dong 149, Gangdong-gu, Seoul, 134-727, Republic of Korea

    Chang-Woo Ryu

  2. Department of Neurosurgery, Seoul National University Bundang Hospital, Sungnam, Republic of Korea

    O-Ki Kwon

  3. Department of Neurosurgery, Kyung Hee University Hospital at Gangdong, Sangil-dong 149, Gangdong-gu, Seoul, Republic of Korea

    Jun Seok Koh

  4. Department of Radiology, Kyung Hee University Hospital, Sangil-dong 149, Gangdong-gu, Seoul, Republic of Korea

    Eui Jong Kim

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  1. Chang-Woo Ryu
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  2. O-Ki Kwon
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Correspondence to Chang-Woo Ryu.

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Ryu, CW., Kwon, OK., Koh, J.S. et al. Analysis of aneurysm rupture in relation to the geometric indices: aspect ratio, volume, and volume-to-neck ratio. Neuroradiology 53, 883–889 (2011). https://doi.org/10.1007/s00234-010-0804-4

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  • DOI: https://doi.org/10.1007/s00234-010-0804-4

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