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Aneurysm Wall Enhancement in Unruptured Intracranial Aneurysms: A Histopathological Evaluation.

Abstract：

:Background Unruptured intracerebral aneurysm wall enhancement (AWE) on vessel wall magnetic resonance imaging scans may be a promising predictor for rupture-prone intracerebral aneurysms. However, the pathophysiology of AWE remains unclear. To this end, the association between AWE and histopathological changes was assessed in this study. Methods and Results A total of 35 patients with 41 unruptured intracerebral aneurysms who underwent surgical clipping were prospectively enrolled. A total of 27 aneurysms were available for histological evaluation. The macroscopic and microscopic features of unruptured intracerebral aneurysms with and without enhancement were assessed. The microscopic features studied included inflammatory cell invasion and vasa vasorum, which were assessed using immunohistochemical staining with CD68, CD3, CD20, and myeloperoxidase for the former and CD34 for the latter. A total of 21 (51.2%) aneurysms showed AWE (partial AWE, n=7; circumferential AWE, n=14). Atherosclerotic and translucent aneurysms were identified in 17 and 14 aneurysms, respectively. Aneurysm size, irregularity, and atherosclerotic and translucent aneurysms were associated with AWE on univariate analysis (P<0.05). Multivariate logistic regression analysis showed that atherosclerosis was the only factor significantly and independently associated with AWE (P=0.027). Histological assessment revealed that inflammatory cell infiltration, intraluminal thrombus, and vasa vasorum were significantly associated with AWE (P<0.05). Conclusions Though AWE on vessel wall magnetic resonance imaging scans may be associated with the presence of atherosclerotic lesions in unruptured intracerebral aneurysms, inflammatory cell infiltration within atherosclerosis, intraluminal thrombus, and vasa vasorum may be the main pathological features associated with AWE. However, the underlying pathological mechanism for AWE still needs to be further studied.

journal_name

J Am Heart Assoc

journal_title

Journal of the American Heart Association

authors

Zhong W,Su W,Li T,Tan X,Chen C,Wang Q,Wang D,Su W,Wang Y

doi

10.1161/JAHA.120.018633

subject

Has Abstract

pub_date

2021-01-19 00:00:00

pages

e018633

issue

2

issn

2047-9980

journal_volume

10

pub_type

杂志文章

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