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CC BY-NC-ND 4.0 · Indian J Radiol Imaging 2026; 36(01): 069-075
DOI: 10.1055/s-0045-1807748
Original Article

Beyond the Lumen: Role of High-Resolution Magnetic Resonance Vessel Wall Imaging in Assessing Intracranial Aneurysms—A Prospective Observational Study from North India

Autor*innen

  • Shumyla Jabeen

    1   Department of Radiodiagnosis and Imaging, Sher-i-Kashmir Institute of Medical Sciences, Srinagar, Kashmir, India

  • Mudasir Hamid Bhat

    1   Department of Radiodiagnosis and Imaging, Sher-i-Kashmir Institute of Medical Sciences, Srinagar, Kashmir, India

  • Mujtaba Tahir Gani

    1   Department of Radiodiagnosis and Imaging, Sher-i-Kashmir Institute of Medical Sciences, Srinagar, Kashmir, India

  • Naseer A. Choh

    1   Department of Radiodiagnosis and Imaging, Sher-i-Kashmir Institute of Medical Sciences, Srinagar, Kashmir, India

  • Irfan Robbani

    1   Department of Radiodiagnosis and Imaging, Sher-i-Kashmir Institute of Medical Sciences, Srinagar, Kashmir, India

  • Sheikh Riaz Rasool

    1   Department of Radiodiagnosis and Imaging, Sher-i-Kashmir Institute of Medical Sciences, Srinagar, Kashmir, India

  • Sarbjit Singh Chhiber

    2   Department of Neurosurgery, Sher-i-Kashmir Institute of Medical Sciences, Srinagar, Kashmir, India

  • Feroze Shaheen

    1   Department of Radiodiagnosis and Imaging, Sher-i-Kashmir Institute of Medical Sciences, Srinagar, Kashmir, India

  • Tahleel Altaf Shera 

    1   Department of Radiodiagnosis and Imaging, Sher-i-Kashmir Institute of Medical Sciences, Srinagar, Kashmir, India

  • Abdul Rashid Bhat

    2   Department of Neurosurgery, Sher-i-Kashmir Institute of Medical Sciences, Srinagar, Kashmir, India

Funding None.
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Abstract

Background

Intracranial aneurysm rupture leading to subarachnoid hemorrhage (SAH) is associated with high morbidity and mortality. While conventional imaging modalities like computed tomography (CT) angiography and digital subtraction angiography (DSA) are commonly employed, they primarily visualize the lumen rather than the vessel wall itself. Recent advancements in magnetic resonance vessel wall imaging present an opportunity to explore the role of inflammation in aneurysm rupture, thus also potentially serving as a predictor for rupture risk.

Aims

This study aimed to assess vessel wall enhancement patterns in ruptured and unruptured intracranial aneurysms, correlating these patterns with aneurysm morphology and evaluate the relationship between the PHASES score and enhancement characteristics.

Materials and Methods

Patients with confirmed intracranial aneurysms on CT angiography and/or DSA underwent plain and contrast-enhanced T1 SPACE (sampling perfection with application-optimized contrasts using different flip angle evolution) images to assess vessel wall enhancement, which was classified as absent, focal, or circumferential termed as grade 0, 1, and 2, respectively.

Results

Out of 60 patients included in the study, 60% presented with ruptured aneurysms. All ruptured aneurysms showed vessel wall enhancement, which was circumferential in 46.7% cases. In contrast, only 30% of unruptured aneurysms showed any form of enhancement, which was predominantly grade 1. Statistical analysis revealed a significant association between enhancement patterns and rupture status, with a p-value of < 0.001.

Conclusion

Vessel wall enhancement was observed in all ruptured aneurysms, thus suggesting a potential role of inflammation in the disruption of aneurysm wall integrity. It may thus also serve as a predictor of aneurysm rupture, enhancing clinical decision-making for patient management.

Keywords

aneurysm - vessel wall imaging - rupture - PHASES

Note

This study has not been presented at any previous meeting or conference.




Publikationsverlauf

Artikel online veröffentlicht:
04. Juni 2025

© 2025. Indian Radiological Association. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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