The following is a summary of “Relationships between irregular pulsation and variations in morphological characteristics during the cardiac cycle in unruptured intracranial aneurysms by 4D-CTA,” published in the March 2024 issue of Neurology by Chen et al.

While irregular bulging in an aneurysm wall is linked to potential rupture, its clinical importance and connection to aneurysm shape and size need further investigation.

Researchers conducted a retrospective study to quantify how an aneurysm’s shape changes throughout a heartbeat and see if these changes are linked to irregular bulging, aiming to improve understanding of aneurysm behavior.

They studied 14 unruptured intracranial aneurysms (UIAs) from 11 patients, performing 4D-CTA scans post-diagnosis by DSA. The R-R intervals were segmented into 20-time phases at 5% intervals to assess irregular pulsations during the cardiac cycle. CT images from phases were utilized to reconstruct 3D aneurysm models, evaluate 14 morphological parameters, and quantify both absolute changes and relative rates of change during the cardiac cycle.

The results showed that 7 out of 14 UIAs displayed irregular pulsations during the cardiac cycle via 4D-CTA, among which five were small aneurysms (≤7 mm). UIAs with irregular pulsations exhibited notable changes in morphological characteristics. With increasing aneurysm size, there was an increase in absolute change in aneurysm volume (P=0.035) but a decrease in relative rates of change in aneurysm size (P=0.013), height (P=0.014), width (P=0.008), height-to-width ratio (P=0.009), dome-to-neck ratio (P=0.019), and bottleneck factor (P=0.012).

Investigators found smaller aneurysms with irregular pulsation had larger shape changes, suggesting a potential rupture risk marker using 4D-CTA.

Source: frontiersin.org/journals/neurology/articles/10.3389/fneur.2024.1302874/full