TY - JOUR
T1 - Geometric Features Associated with Middle Cerebral Artery Bifurcation Aneurysm Formation
T2 - A Matched Case-Control Study
AU - Zhang, Jian
AU - Can, Anil
AU - Lai, Pui Man Rosalind
AU - Mukundan, Srinivasan
AU - Castro, Victor M.
AU - Dligach, Dmitriy
AU - Finan, Sean
AU - Gainer, Vivian S.
AU - Shadick, Nancy A.
AU - Savova, Guergana
AU - Murphy, Shawn N.
AU - Cai, Tianxi
AU - Weiss, Scott T.
AU - du, Rose.
N1 - Funding Information: This study was supported by Partners Personalized Medicine (RD), the National Institutes of Health ( U54 HG007963: TC and SM, U01 HG008685: SM, and R01 HG009174: SM ), and National Natural Science Foundation of China ( 81571121 ). Publisher Copyright: © 2021 Elsevier Inc.
PY - 2022/3/1
Y1 - 2022/3/1
N2 - Objectives: The pathogenesis of intracranial aneurysms is multifactorial and includes genetic, environmental, and anatomic influences. We aimed to identify image-based morphological parameters that were associated with middle cerebral artery (MCA) bifurcation aneurysms. Materials and methods: We evaluated three-dimensional morphological parameters obtained from CT angiography (CTA) or digital subtraction angiography (DSA) from 317 patients with unilateral MCA bifurcation aneurysms diagnosed at the Brigham and Women's Hospital and Massachusetts General Hospital between 1990 and 2016. We chose the contralateral unaffected MCA bifurcation as the control group, in order to control for genetic and environmental risk factors. Diameters and angles of surrounding parent and daughter vessels of 634 MCAs were examined. Results: Univariable and multivariable statistical analyses were performed to determine statistical significance. Sensitivity analyses with smaller (≤ 3 mm) aneurysms only and with angles excluded, were also performed. In a multivariable conditional logistic regression model we showed that smaller diameter size ratio (OR 0.0004, 95% CI 0.0001–0.15), larger daughter-daughter angles (OR 1.08, 95% CI 1.06–1.11) and larger parent-daughter angle ratios (OR 4.24, 95% CI 1.77–10.16) were significantly associated with MCA aneurysm presence after correcting for other variables. In order to account for possible changes to the vasculature by the aneurysm, a subgroup analysis of small aneurysms (≤ 3 mm) was performed and showed that the results were similar. Conclusions: Easily measurable morphological parameters of the surrounding vasculature of the MCA may provide objective metrics to assess MCA aneurysm formation risk in high-risk patients.
AB - Objectives: The pathogenesis of intracranial aneurysms is multifactorial and includes genetic, environmental, and anatomic influences. We aimed to identify image-based morphological parameters that were associated with middle cerebral artery (MCA) bifurcation aneurysms. Materials and methods: We evaluated three-dimensional morphological parameters obtained from CT angiography (CTA) or digital subtraction angiography (DSA) from 317 patients with unilateral MCA bifurcation aneurysms diagnosed at the Brigham and Women's Hospital and Massachusetts General Hospital between 1990 and 2016. We chose the contralateral unaffected MCA bifurcation as the control group, in order to control for genetic and environmental risk factors. Diameters and angles of surrounding parent and daughter vessels of 634 MCAs were examined. Results: Univariable and multivariable statistical analyses were performed to determine statistical significance. Sensitivity analyses with smaller (≤ 3 mm) aneurysms only and with angles excluded, were also performed. In a multivariable conditional logistic regression model we showed that smaller diameter size ratio (OR 0.0004, 95% CI 0.0001–0.15), larger daughter-daughter angles (OR 1.08, 95% CI 1.06–1.11) and larger parent-daughter angle ratios (OR 4.24, 95% CI 1.77–10.16) were significantly associated with MCA aneurysm presence after correcting for other variables. In order to account for possible changes to the vasculature by the aneurysm, a subgroup analysis of small aneurysms (≤ 3 mm) was performed and showed that the results were similar. Conclusions: Easily measurable morphological parameters of the surrounding vasculature of the MCA may provide objective metrics to assess MCA aneurysm formation risk in high-risk patients.
KW - Aneurysm
KW - Middle cerebral artery
KW - Morphology
KW - Subarachnoid hemorrhage
UR - http://www.scopus.com/inward/record.url?scp=85122084409&partnerID=8YFLogxK
U2 - https://doi.org/10.1016/j.jstrokecerebrovasdis.2021.106268
DO - https://doi.org/10.1016/j.jstrokecerebrovasdis.2021.106268
M3 - Article
C2 - 34974241
SN - 1052-3057
VL - 31
JO - Journal of Stroke and Cerebrovascular Diseases
JF - Journal of Stroke and Cerebrovascular Diseases
IS - 3
M1 - 106268
ER -