Evidence map›Paper›PMID 32666320›Full record

ArticleEuropean radiology2020

Wall enhancement on black-blood MRI is independently associated with symptomatic status of unruptured intracranial saccular aneurysm.

Chengcheng Zhu, Xinrui Wang, Laura Eisenmenger, Zhang Shi, Andrew Degnan, Bing Tian, Qi Liu, Christopher Hess, David Saloner, Jianping Lu

Abstract read
PubMed Publisher
In one paragraph

Article in European radiology, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
16citing papers in PubMed, 2 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

16 citing papers in PubMed, 2 syntheses or guidelines pooled it.

  1. Pooled it
  2. Pooled it
  3. Article
  4. Article
  5. Article
  6. Article
  7. Article
  8. Article
  9. Article
  10. Article
  11. Article
  12. Article
  13. Article
  14. Article
  15. Article
  16. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Chengcheng Zhu *Department of Radiology and Biomedical Imaging, UCSF, San Francisco, CA, USA.
Xinrui Wang *Department of Radiology, Changhai Hospital, Shanghai, China.
Laura EisenmengerDepartment of Radiology, University of Wisconsin, Madison, WI, USA.
Zhang ShiDepartment of Radiology, Changhai Hospital, Shanghai, China.
Andrew DegnanDepartment of Radiology, Children's Hospital of Philadelphia, Philadelphia, PA, USA.
Bing TianDepartment of Radiology, Changhai Hospital, Shanghai, China.
Qi LiuDepartment of Radiology, Changhai Hospital, Shanghai, China.
Christopher HessDepartment of Radiology and Biomedical Imaging, UCSF, San Francisco, CA, USA.
David SalonerDepartment of Radiology and Biomedical Imaging, UCSF, San Francisco, CA, USA.
Jianping LuDepartment of Radiology, Changhai Hospital, Shanghai, China. cjr.lujianping@vip.163.com.ORCID http://orcid.org/0000-0002-0380-7470

Funding

Characterization of intracranial vessel wall morphology and inflammation using 3D high resolution MRIK99HL136883 · NHLBI · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI ZHU, CHENGCHENG · 2017 to 2018
$181k
Natural Science Foundation of Liaoning Province 2019-BS-267NHLBI NIH HHS K99HL136883
6 · The paper itself

Abstract

objectiveThis study aims to investigate whether aneurysm wall enhancement (AWE) is independently associated with symptomatic status of unruptured intracranial aneurysms (UIAs).

methodsOne hundred thirty-nine consecutive patients (67 male, mean age 58 ± 11 years) with 79 symptomatic and 87 asymptomatic UIAs were imaged using black-blood MRI pre- and post-gadolinium contrast administration and 3D DSA. Symptoms related to aneurysms were identified including cranial nerve deficits and headache. AWE grade and area were characterized, and aneurysm size was measured on DSA. Multivariate binary logistic regression analysis was used to identify factors associated with symptoms. Further subgroup analysis was performed for aneurysms size < 10 mm.

resultsSymptomatic UIAs had significantly larger aneurysm size (11.2 ± 6.2 mm vs. 6.4 ± 3.3 mm), enhancement grade (1.3 ± 0.6 vs. 0.4 ± 0.6), enhancement area (2.0 ± 0.9 vs. 0.4 ± 0.7), and higher prevalence of thick enhancement (39% vs. 3%) compared with asymptomatic UIAs, all p < 0.001. In multivariate analysis, only AWE area (odds ratio [OR] 6.9, 95% confidence interval [4.0, 11.7]) was independently associated with symptoms. AWE area had an area under curve (AUC) value of 0.888, with 72.2% sensitivity and 92.0% specificity for symptoms, which was superior to aneurysm size (AUC of 0.771, with 75.9% sensitivity and 65.5% specificity). In the subgroup analysis of aneurysms smaller than 10 mm (n = 118), AWE area (OR, 7.0, p < 0.001) remained the only independent risk factor associated with symptoms.

conclusionsLarger AWE area is independently associated with symptomatic UIAs, which may provide additional value to guide UIA management and improve patient outcomes. KEY POINTS: • Symptomatic intracranial aneurysms are larger and more often demonstrate significant wall enhancement than asymptomatic aneurysms. • Larger wall enhancement area is independently associated with symptomatic intracranial aneurysm.

Indexed as

Contrast MediaBrainFemaleHumansImage EnhancementIntracranial AneurysmMagnetic Resonance ImagingMaleMiddle AgedMultivariate AnalysisOdds RatioRisk FactorsSensitivity and SpecificityContrast MediaGadoliniumIntracranial aneurysmMagnetic resonance imaging

Identifiers

PMID32666320

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

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.