Source:Academic Radiology
Author(s): Xinrui Wang, Chengcheng Zhu, Yue Leng, Andrew J. Degnan, Jianping Lu
Rationale and ObjectivesAneurysm wall enhancement (AWE) on magnetic resonance vessel wall imaging has been proposed as an imaging marker of aneurysm wall inflammation and instability. We performed a systematic review and meta-analysis to summarize the association between AWE and aneurysm rupture.Materials and MethodsWe performed a comprehensive literature search of studies evaluating the association between AWE and aneurysm rupture. We abstracted the following study data: study design, patient demographics, aneurysm characteristics, MRI protocols, and AWE assessment. We performed meta-analysis using a random-effects model. Study heterogeneity was assessed by using the Cochrane Q and I2 statistic, and publication bias was examined by using the Begg–Mazumdar test.ResultsFive studies with 492 subjects met eligibility for systematic review. We found a significant positive overall association between AWE and aneurysm rupture, with an odds ratio (OR) of 34.26 (95% confidence interval [CI] 10.20–115.07, p < 0.001). No significant heterogeneity (Q = 5.38, p = 0.25; I2 = 26%) or publication bias (p = 1.000) was present. In the separate analysis of circumferential AWE and aneurysm rupture, we identified marked heterogeneity across studies (Q = 21.23, p < 0.001; I2 = 86%). Further subgroup analysis considering the effect of aneurysm size showed that the strength of association between circumferential AWE and aneurysm rupture was significant in small aneurysms (<7mm), with an OR of 26.12 (95% CI 6.11–111.75, p < 0.001), but limited in large aneurysms (OR = 0.56, 95% CI [0.21, 1.44], p = 0.23).ConclusionAWE on magnetic resonance vessel wall imaging is significantly and independently associated with aneurysm rupture and may become a promising imaging marker to predict aneurysm behavior and identify high-risk aneurysms.
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