AUTHOR=Tang Xiaoyu , Zhou Longjiang , Wen Lili , Wu Qi , Leng Xiaochang , Xiang Jianping , Zhang Xin 

TITLE=Morphological and Hemodynamic Characteristics Associated With the Rupture of Multiple Intracranial Aneurysms

JOURNAL=Frontiers in Neurology

VOLUME=Volume 12 - 2021

YEAR=2022

URL=https://www.frontiersin.org/journals/neurology/articles/10.3389/fneur.2021.811281

DOI=10.3389/fneur.2021.811281

ISSN=1664-2295

ABSTRACT=ABSTRACT
Background and Purpose: The objective of this study was to identify the morphological and hemodynamic factors associated with rupture of multiple intracranial aneurysms regardless of patient-related factors and establish a statistical model for aneurysm rupture risk assessment.
Methods: The digital subtraction angiography (DSA) data of 104 mirror intracranial aneurysms in 52 consecutive patients were analyzed in this study retrospectively. 21 morphological parameters and hemodynamic parameters were calculated by 3-dimensional reconstruction and computational fluid dynamics (CFD) simulation. Significant differences (p＜0.05) between the two groups were subsequently tested with multivariate logistic regression to identify the independent risk factors. A prediction model was established based on the independent risk factors. Receiver operating characteristics (ROC) were generated to estimate the prediction performance. A cohort of patients with multiple intracranial aneurysms admitted in our institute from January 2021 to October 2021 was introduced to verify the value of the model. 
Results: Significant differences between ruptured and unruptured aneurysms were found in 15 out of 19 parameters. Bleb formation, Neck width and size ratio were independent factors in the multivariate regression. A prediction model based on the three independent risk factors was established: Odds=-1.495-0.707×(Neck width)+3.061×(Bleb formation)+2.1×(SR)( Bleb formation: Yes=1, No=0).The area under the curve (AUC) value of the model was 0.901. In the validation cohort, the prediction model showed satisfying performance in assessing multiple aneurysm rupture risk with a sensitivity of 100% and specificity of 88.46%.
Conclusion: Bleb formation, neck width and size ratio were independently associated with aneurysm rupture status. The prediction model may help in identifying the aneurysm with high rupture risk.