Evidence map›Paper›PMID 41579209›Full record

Observational studyNeurosurgical review2026

Analysis of symptomatic brain aneurysms with three-dimensional aneurysm wall enhancement.

Chengcheng Zhu, Elena Sagues, Bing Tian, Huilin Zhao, Andres Gudino, Navami Shenoy, Diego Ojeda, Carlos Dier, Arshaq Saleem, Linder Wendt and 9 more

Abstract readMulticenter StudyObservational Study
In one paragraph

Observational study in Neurosurgical review, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–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

1 citing paper in PubMed.

  1. 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

19 authors.

Chengcheng ZhuDepartment of Radiology, University of Washington, Seattle, USA.
Elena SaguesDepartment of Neurology, University of Iowa, 200 Hawkins Dr., Iowa City, IA, 52242, USA.
Bing TianDepartment of Radiology, Changhai Hospital, Shanghai, China.
Huilin ZhaoDepartment of Radiology, Renji Hospital, Shanghai, China.
Andres GudinoDepartment of Neurology, University of Iowa, 200 Hawkins Dr., Iowa City, IA, 52242, USA.
Navami ShenoyDepartment of Neurology, University of Iowa, 200 Hawkins Dr., Iowa City, IA, 52242, USA.
Diego OjedaDepartment of Neurology, University of Connecticut, Hartford, CT, USA.
Carlos DierDepartment of Neurology, University of Iowa, 200 Hawkins Dr., Iowa City, IA, 52242, USA.
Arshaq SaleemCarver College of Medicine, University of Iowa, Iowa City, IA, USA.
Linder WendtInstitute for Clinical and Translational Science, University of Iowa, Iowa City, IA, USA.
Sebastian SanchezDepartment of Neurology, Yale University, New Haven, CT, USA.
Jacob M MillerDepartment of Neurology, University of Iowa, 200 Hawkins Dr., Iowa City, IA, 52242, USA.
Luis NoboaDepartment of Neurology, University of Iowa, 200 Hawkins Dr., Iowa City, IA, 52242, USA.
Katherine Guijarro-FalconDepartment of Neurology, University of Iowa, 200 Hawkins Dr., Iowa City, IA, 52242, USA.
Matthew T JonesDepartment of Neurology, University of Iowa, 200 Hawkins Dr., Iowa City, IA, 52242, USA.
Randall KrugDepartment of Neurology, University of Iowa, 200 Hawkins Dr., Iowa City, IA, 52242, USA.
Santiago Ortega-GutierrezDepartment of Neurology, University of Iowa, 200 Hawkins Dr., Iowa City, IA, 52242, USA.
David HasanDepartment of Neurosurgery, Duke University, Durham, NC, USA.
Edgar A SamaniegoDepartment of Neurology, University of Iowa, 200 Hawkins Dr., Iowa City, IA, 52242, USA. edgarsama@gmail.com.

Funding

University of Iowa Institute for Clinical and Translational ScienceUM1TR004403 · NCATS · UNIVERSITY OF IOWA · PI Marlan R Hansen, Patricia Winokur · 2023 to 2026
$16.1M
NCATS NIH HHS UM1 TR004403NCATS NIH HHS UM1TR004403
6 · The paper itself

Abstract

objectiveTo determine whether three-dimensional quantitative assessment of aneurysm wall enhancement (AWE) improves the identification of high-risk intracranial aneurysms (IAs) compared to existing risk scoring systems. This cross-sectional, multicenter observational study included patients with saccular IAs who prospectively underwent 3T high-resolution MRI between 2018 and 2023 at the University of Iowa, Changhai Hospital, and Ren Ji Hospital. IAs were classified as symptomatic if associated with rupture, sentinel headache, cranial nerve palsy, or neurological symptoms due to mass effect. AWE was quantified using three-dimensional aneurysm wall mapping. The diagnostic performance of the PHASES score was compared to a multivariate logistic regression model developed using all-subsets regression, incorporating PHASES components along with sex, smoking status, aneurysm morphology, and AWE data. A total of 334 patients with 387 saccular IAs were analyzed; 73 aneurysms (19%) were symptomatic. In multivariate analysis, three-dimensional circumferential AWE (3D-CAWE) was independently associated with symptomatic presentation (OR 6.1, 95% CI 2.1–19.5; p < 0.001). The PHASES score achieved an area under the curve (AUC) of 0.64 (95% CI 0.56–0.71) for discriminating symptomatic IAs. A comprehensive model including age, smoking status, size ratio, and 3D-CAWE significantly outperformed PHASES, achieving an AUC of 0.80 (95% CI 0.74–0.85; ΔAUC = 0.16, 95% CI 0.09–0.23; p < 0.001). A comprehensive risk model that integrates clinical variables, aneurysm morphological features, and 3D-CAWE significantly improves the classification of symptomatic IAs compared to the PHASES score alone.

Indexed as

Imaging, Three-DimensionalIntracranial AneurysmAdultAgedCross-Sectional StudiesFemaleHumansMagnetic Resonance ImagingMaleMiddle AgedProspective StudiesMagnetic resonance imagingSubarachnoid hemorrhageUnruptured intracranial aneurysmsVessel wall

Identifiers

PMID41579209
PMCPMC12831663

What OpenQuestion holds

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LicenceCC BY
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.