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Imaging markers of intracranial aneurysm development: A systematic review - 15/10/21

Doi : 10.1016/j.neurad.2021.09.001 
Angelina K. Kancheva a, , Birgitta K. Velthuis b, Ynte M. Ruigrok a
a Brain Center Rudolf Magnus, Department of Neurology and Neurosurgery, University Medical Center Utrecht, Utrecht University, the Netherlands 
b Department of Radiology, University Medical Center Utrecht, Utrecht University, the Netherlands 

Corresponding author at: Brain Center Rudolf Magnus, Department of Neurology and Neurosurgery, University Medical Center Utrecht, Heidelberglaan 100.Brain Center Rudolf MagnusDepartment of Neurology and NeurosurgeryUniversity Medical Center UtrechtHeidelberglaan 100
En prensa. Pruebas corregidas por el autor. Disponible en línea desde el Friday 15 October 2021
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Highlights

We systematically reviewed imaging markers of intracranial aneurysm development.
Many studies had poor methodological quality and varied in marker definitions and outcomes used.
We only found one anatomical imaging marker with converging evidence, A1 segment asymmetry.
A meta-analysis was however not possible due to the use of different definitions of A1 asymmetry across studies.
Future studies should employ robust study designs to clarify the role of the identified markers.

El texto completo de este artículo está disponible en PDF.

Abstract

Background

Imaging markers of intracranial aneurysm (IA) development are not well established.

Purpose

To provide an overview of imaging markers of IA development.

Methods

A systematic search of PubMed and Embase up to December 1st 2020 using predefined criteria. Thirty-six studies met our inclusion criteria. We performed a quantitative summary of the included studies.

Results

We found converging evidence for A1 segment asymmetry as an anatomical marker of anterior communicating artery (Acom) aneurysm development, and moderate evidence for several other markers. No hemodynamic markers yielded converging or moderate evidence. There was large heterogeneity across studies, especially in the definitions of imaging markers and study outcomes used. Due to the poor methodological quality of many studies and unavailability of effect sizes or crude data to calculate effect sizes, a formal meta-analysis was not possible. Many studies had poor methodological quality and varied inmarkerdefinitions and outcome measuresused, which prevented us from performing a formal meta-analysis.

Conclusions

We only identified A1 segment asymmetry as an imaging marker of Acom aneurysm development with converging evidence. A meta-analysis was not possible due to the heterogeneity of marker definitions and outcomes used, and poor methodological quality of many studies. Future studies should use robust study designs and uniformly defined imaging markers and outcome measures.

El texto completo de este artículo está disponible en PDF.

Graphical abstract




Image, graphical abstract

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Keywords : Imaging marker, Intracranial aneurysm, Neuroimaging, Subarachnoid hemorrhage

Abbreviations : ACA, BA, IA, ICA, MCA, PCA, Pcom, VA, WSS


Esquema


 Disclosure of Funding
We acknowledge the support from the Netherlands Cardiovascular Research Initiative: An initiative with support of the Dutch Heart Foundation, CVON2015-08 ERASE. This project has received funding from the European Research Council (ERC) under the European Union's Horizon 2020 research and innovation program (grant agreement No. 852173).
 Conflict of Interest
None.


© 2021  The Author(s). Publicado por Elsevier Masson SAS. Todos los derechos reservados.
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