AJNR. American journal of neuroradiology · 2026
Quantitative MRA Feature Prediction of Postaneurysmal Subarachnoid Hemorrhage Delayed Cerebral Ischemia and Angiographic Vasospasm.
СтатьяНазвание и аннотация: Перевод в очереди
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Mosi Mohamad H, Kharaji Mona, Aksakal Mehmet, Zhang Kaiyu, Watt Charles, Cheng Dan, Levitt Michael R, Canton Gador, Yuan Chun, Balu Niranjan, Mossa-Basha Mahmud
Аннотация
BACKGROUND AND PURPOSE: Complications of aneurysmal SAH (aSAH), including vasospasm and delayed cerebral ischemia (DCI), substantially contribute to morbidity and mortality. We investigated the correlation between quantitative measurements on MRA performed immediately after endovascular embolization and subsequent development of DCI or vasospasm.
MATERIALS AND METHODS: We included consecutive patients scanned between September 1, 2016 and January 14, 2022 with ruptured intracranial aneurysms (IAs) after endovascular treatment. We recorded clinical data including sex, age, body mass index (BMI), smoking history, vascular risk factors, baseline CTA/CT features, modified Fisher score, and Glasgow Coma Score. We extracted quantitative MRA features, including total arterial length, total branch number, and average tortuosity, using a custom semiautomated software (VesselVoyager). Correlations among baseline quantitative MRA and other imaging and clinical features with DCI and vasospasm were determined using logistic regression analysis. Receiver operating characteristic (ROC) curves were calculated for clinical-only models and for models augmented with quantitative MRA features.
RESULTS: Seventy-eight patients with ruptured IAs were included, of whom 48 developed vasospasm and 24 developed DCI. Multivariable logistic regression analysis showed that only average tortuosity was significantly and independently associated with subsequent DCI (OR 0.62; 95% CI, 0.39-0.91; P = .02). For vasospasm, total arterial length (OR 0.87; 95% CI, 0.78-0.95; P = .005), average tortuosity (OR 0.37; 95% CI, 0.18-0.62; P = .001), and age (OR 0.92; 95% CI, 0.86-0.98; P = .02) were independently associated with vasospasm incidence on multivariable regression. Adding quantitative MRA features improved ROC performance for both DCI (area under the receiver operating characteristic curve 0.63 [95% CI, 0.51-0.75]) vs 0.75 [95% CI, 0.64-0.87]) and vasospasm (area under the receiver operating characteristic curve 0.67 [95% CI, 0.54-0.79] vs 0.85 [95% CI, 0.77-0.94]).
CONCLUSIONS: In patients with aSAH, average tortuosity is independently inversely associated with future development of DCI. Total branch number and average tortuosity are independently inversely associated with future vasospasm. With further validation, quantitative MRA features may serve as predictive markers for DCI and vasospasm after aSAH.
MATERIALS AND METHODS: We included consecutive patients scanned between September 1, 2016 and January 14, 2022 with ruptured intracranial aneurysms (IAs) after endovascular treatment. We recorded clinical data including sex, age, body mass index (BMI), smoking history, vascular risk factors, baseline CTA/CT features, modified Fisher score, and Glasgow Coma Score. We extracted quantitative MRA features, including total arterial length, total branch number, and average tortuosity, using a custom semiautomated software (VesselVoyager). Correlations among baseline quantitative MRA and other imaging and clinical features with DCI and vasospasm were determined using logistic regression analysis. Receiver operating characteristic (ROC) curves were calculated for clinical-only models and for models augmented with quantitative MRA features.
RESULTS: Seventy-eight patients with ruptured IAs were included, of whom 48 developed vasospasm and 24 developed DCI. Multivariable logistic regression analysis showed that only average tortuosity was significantly and independently associated with subsequent DCI (OR 0.62; 95% CI, 0.39-0.91; P = .02). For vasospasm, total arterial length (OR 0.87; 95% CI, 0.78-0.95; P = .005), average tortuosity (OR 0.37; 95% CI, 0.18-0.62; P = .001), and age (OR 0.92; 95% CI, 0.86-0.98; P = .02) were independently associated with vasospasm incidence on multivariable regression. Adding quantitative MRA features improved ROC performance for both DCI (area under the receiver operating characteristic curve 0.63 [95% CI, 0.51-0.75]) vs 0.75 [95% CI, 0.64-0.87]) and vasospasm (area under the receiver operating characteristic curve 0.67 [95% CI, 0.54-0.79] vs 0.85 [95% CI, 0.77-0.94]).
CONCLUSIONS: In patients with aSAH, average tortuosity is independently inversely associated with future development of DCI. Total branch number and average tortuosity are independently inversely associated with future vasospasm. With further validation, quantitative MRA features may serve as predictive markers for DCI and vasospasm after aSAH.