ArticleAJNR. American journal of neuroradiology2018
Vessel Wall Enhancement in Unruptured Intracranial Aneurysms: An Indicator for Higher Risk of Rupture? High-Resolution MR Imaging and Correlated Histologic Findings.
Article in AJNR. American journal of neuroradiology, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT06405971 (Metformin in Patients With Unruptured Vertebrobasilar Dissecting Aneurysms), which is not on this map. Cited by 88 papers, 3 of them syntheses that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Metformin in Patients With Unruptured Vertebrobasilar Dissecting Aneurysms: a Prospective, Randomized Study (METTLE)
Who cites it
88 citing papers in PubMed, 3 syntheses or guidelines pooled it, 142 citations in OpenAlex.
- A Systematic Review and Meta-Analysis of the Pathology Underlying Aneurysm Enhancement on Vessel Wall Imaging.International journal of molecular sciences · 2024Pooled it
- The association between hemodynamics and wall characteristics in human intracranial aneurysms: a review.Neurosurgical review · 2022Pooled it
- Intracranial aneurysm wall enhancement as an indicator of instability: a systematic review and meta-analysis.European journal of neurology · 2021Pooled it
- Intracranial aneurysms as a manifestation of premature vascular aging: Cellular senescence, inflammaging, and wall degeneration.Ageing research reviews · 2026Review
- Associations between middle cerebral artery tortuosity, aneurysm wall enhancement, and hemodynamics assessed by four-dimensional-flow and high-resolution magnetic resonance imaging.Neuroradiology · 2026Article
- Circumferential wall enhancement is associated with neutrophil-to-lymphocyte ratio in intracranial fusiform aneurysms.Neuroradiology · 2026Article
- Expert consensus on intracranial vessel wall MRI in cerebrovascular disease: Society for Magnetic Resonance Angiography recommendations.European radiology · 2026Review
- Aneurysm Wall Enhancement in Patients With Unruptured Intracranial Aneurysm Using Aspirin or Statins: A Cross-Sectional Analysis of Three Prospective Cohorts.AJNR. American journal of neuroradiology · 2026Article
- Vessel wall enhancement in brain arteriovenous malformations: associations with imaging and histopathological markers of instability.Neurosurgical review · 2026Article
- Chapter 1: The Natural History of Intracranial Aneurysms.Brain sciences · 2026Review
- Aneurysm Wall Enhancement and Probability of Instability in Unruptured Intracranial Aneurysms: A Long-Term Follow-Up Study.Annals of neurology · 2026Article
- Serial vessel wall imaging reveals rupture site and treatment response in a flow-related aneurysm associated with an arteriovenous malformation: illustrative case.Journal of neurosurgery. Case lessons · 2026Article
- High-Resolution Vessel Wall Imaging for Treatment Sequencing of Multiple Aneurysms in Subarachnoid Hemorrhage.Journal of neurological surgery. Part B, Skull base · 2026Article
- Collagen Imaging in Human Intracranial Aneurysms - a Translational Proof-of-Concept Study.Translational stroke research · 2026Article
- Sex difference in predictors of aneurysmal wall enhancement: a cross-sectional and prospective cohort study.Neuroradiology · 2026Article
- Appearance and Disappearance of Intracranial Aneurysm Wall Enhancement during Follow-Up: A Multicenter Cohort Study.AJNR. American journal of neuroradiology · 2025Article
- Mechanisms of Intracranial Aneurysm Rupture: An Integrative Review of Experimental and Clinical Evidence.Journal of clinical medicine · 2025Review
- Perianeurysmal edema after coil embolization of a giant ruptured aneurysm: illustrative case.Journal of neurosurgery. Case lessons · 2025Article
- Intracranial vessel wall lesions on MRI: anatomical and pathological issues.Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2025Review
- Evaluation of radiogenomics for risk stratification of intracranial aneurysms: a pilot study.Neuroradiology · 2025Article
28 more citing papers are in PubMed but not listed here.
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Authors and funding
9 authors at 4 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
background and purposeRecent studies have suggested that wall enhancement of unruptured intracranial aneurysms in high-resolution MR imaging might serve as an imaging biomarker for higher risk of rupture. Histologic studies have revealed a possible association among inflammatory processes, degeneration, and destabilization of the aneurysm wall preceding rupture. Understanding the histologic condition underlying aneurysm wall enhancement could be an important step toward assessing the value of this method for risk stratification. We present our observations of aneurysm wall enhancement in MR vessel wall imaging and underlying histologic changes. MATERIALS AND
methodsWe reviewed records of patients with an unruptured middle cerebral artery aneurysm who underwent MR vessel wall imaging before aneurysm clipping. Contrast enhancement of the aneurysm wall was dichotomized into either none/faint or strong. Histologic analysis included myeloperoxidase stain for detection of inflammatory cell invasion and CD34 stain for assessment of neovascularization and vasa vasorum.
resultsThirteen aneurysms were included. Five aneurysms showed strong wall enhancement. Among these, myeloperoxidase staining revealed inflammatory cell infiltration in 4. Three showed neovascularization. In 2 aneurysms, vasa vasorum were present. Seven aneurysms did not show wall enhancement; 1 had only mild enhancement. None of these bore evidence of inflammatory cell invasion or neovascularization, and they all lacked vasa vasorum.
conclusionsWall enhancement in MR vessel wall imaging is associated with inflammatory cell invasion, neovascularization, and the presence of vasa vasorum. Enhancement does not occur when histologic signs of inflammation are absent. Our results support the hypothesis that MR vessel wall imaging could provide valuable information for risk stratification.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.