Research ArticleOriginal Article
Open Access

The interrelated effects of 2D angiographic morphological variables and aneurysm rupture

Tianlun Qiu, Guoliang Jin and Wuqiao Bao
Neurosciences Journal July 2014, 19 (3) 210-217;

Article Figures & Data

Figures

  • Figure 1
    Figure 1

    Sidewall aneurysm measurements. Patient (male, 46 years) was hospitalized because of acute headache for one day. Head CT showed subarachnoid hemorrhage. Two days later 2 aneurysms in each carotid were found on digital subtraction angiography. The left carotid aneurysm is shown: maximal diameter (Dmax), longest dimension from the center of the neck to the dome tip (Hmax or height), maximal longitudinal diameter parallel with the neck plane (Wortho), dome width perpendicular to height (Wmax), the angle between axis of flow in the parent vessel at the level of the aneurysm neck and the aneurysm’s main axis from the center of the neck to the tip of the dome (inflow angle). The average value of both sides of the aneurysm neck=D1+D2/2 (average parent artery diameter).

  • Figure 2
    Figure 2

    Bifurcation aneurysm assessments. Patient (male, 66 years) was hospitalized because of acute headache for one day. Head CT showed subarachnoid hemorrhage. Two days later 2 aneurysms in the left middle cerebral artery and right posterior communicating artery respectively were found on digital subtraction angiography. The left middle cerebral aneurysm is shown: Maximal diameter (Dmax), longest dimension from the center of the neck to the dome tip (Hmax or Height), maximal longitudinal diameter parallel with the neck plane (Wortho), dome width perpendicular to height (Wmax), the angle between axis of flow in the parent vessel and the aneurysm’s main axis from the center of the neck to the tip of the dome (inflow angle). The average value of artery diameter=D1+D2+D3/3.

Tables

  • Table 1

    Basic data of 34 multiple cerebral aneurysm patients with 76 aneurysms.*

    VariableNumber (%) and type of aneurysms
    1R:1UR1R:2UR1R:3URTotal
    Patients27/34 (79.4)6/34 (17.7)1/34 (2.9)34/34 (100)
    Age (mean±SD)55.9±11.156.2±9.454855.79±10.64
    Male:Female13:141:51:015:19
    Hypertension9/27 (33.3)3/6 (50.0)1/1 (100)13 (38.2)
    Smoking5/27 (18.5)2/6 (33.3)1/1 (100)8 (23.5)

    • ↵* Data presented as number of ruptured aneurysms (R) and unruptured aneurysms (U)

  • Table 2

    Comparisons of morphological aneurysm parameters between ruptured and unruptured aneurysms.*

    ParameterRuptured (34 aneurysms)Unruptured (42 aneurysms)Mann-Whitney UZP-value
    Dmax (mm)4.50 (4.14)2.10 (2.38)318.500-4.1360.000
    Hmax (mm)4.16 (3.07)2.00 (1.55)294.000-4.3960.000
    Aspect ratio1.95 (1.31)1.05 (0.39)293.500-4.3940.000
    Bottleneck factor1.72 (0.99)1.03 (0.27)413.500-3.1900.001
    Bulge location0.35 (0.50)0.10 (0.40)515.500-2.1630.031
    Size ratio2.12 (2.04)0.83 (0.47)157.500-5.8140.000
    Height-width ratio1.12 (0.75)0.95 (0.13)265.000-4.6950.000
    Inflow angle (°)129.50 (56.75)90.00 (39.00)326.500-4.0570.000

    • ↵* Data presented as median and (interquartile range)

  • Table 3

    Evaluation of the risk factors of size ratio and height-width ratio with aneurysm rupture by binary logistic regression analyses.

    VariableBS.E.WaldPOR95% CI
    Constant-5.3461.26417.8870.0010.005
    Size ratio
     <113.9830.001
     ≥1 ≤1.62.3920.8727.5200.00610.9311.98-60.39
     >1.63.0660.84313.2360.00121.4624.11-111.96
    Height-width ratio
     ≤1
     >12.1920.69010.1050.0018.9542.32-34.60
    • Table 4

      Spearman correlation coefficients of morphological risk factors by bivariate correlation analysis among multiple cerebral aneurysm patients.

      Bivariate correlationsHmaxAspect ratioBottleneck factorHeight-width ratioBulge locationSize ratioInflow angle
      Dmax0.942† (0.958†)0.627† (0.226)0.438† (0.408†)0.354* (-0.140)0.157 (0.328*)0.726† (0.761†)-0.002 (0.271)
      Hmax-0.574† (0.256)0.520† (0.466†)0.359* (-0.150)0.111 (0.325*)0.728† (0.718†)0.072 (0.314*)
      Aspect ratio--0.546† (0.634†)0.643† (0.479†)0.308 (0.538†)0.684† (0.309*)0.044 (-0.001)
      Bottleneck factor---0.507† (0.007)0.065 (0.722†)0.540† (0.429†)0.035 (0.148)
      Height-width ratio----0.017 (0.155)0.542† (-0.019)-0.034 (-0.010)
      Bulge location-----0.186 (0.491†)-0.153 (0.124)
      Size ratio------0.261 (0.200)

      • ↵* p<0.05,

      • ↵† p<0.01. Data with and without brackets represents spearman correlation coefficients of morphological risk factors in unruptured and ruptured aneurysms; correlation coefficient (R) ≥0.7 indicates strong correlation; 0.7-0.4 indicates moderate correlation, and <0.4 indicates weak correlation

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