Aneurysm Wall Enhancement in Unruptured Intracranial Aneurysms: A Histopathological Evaluation

Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease

Xianjun Tan¹  Wandong Su²  Chao Chen²  Donghai Wang²  Yunyan Wang²  Weiying Zhong²  Tao Li³  Wenjing Su⁴  Qian Wang⁵ 

[1] Department of Neurosurgery People's Hospital of Chiping City Liaocheng Shandong Province China;Department of Neurosurgery Qilu Hospital of Shandong University and Institute of Brain and Brain‐Inspired ScienceShandong University Jinan Shandong Province China;Department of Neurosurgery The No. 4 People's Hospital of Jinan Jinan Shandong Province China;Department of Pathology Shandong Provincial Hospital affiliated with Shandong University Jinan Shandong Province China;Department of Radiology Qilu Hospital of Shandong University Jinan Shandong Province China;

关键词: atherosclerosis;    inflammation;    intracranial aneurysm;    magnetic resonance imaging;    vasa vasorum;   

DOI  :  10.1161/JAHA.120.018633

来源: DOAJ

【 摘 要 】

Background Unruptured intracerebral aneurysm wall enhancement (AWE) on vessel wall magnetic resonance imaging scans may be a promising predictor for rupture‐prone intracerebral aneurysms. However, the pathophysiology of AWE remains unclear. To this end, the association between AWE and histopathological changes was assessed in this study. Methods and Results A total of 35 patients with 41 unruptured intracerebral aneurysms who underwent surgical clipping were prospectively enrolled. A total of 27 aneurysms were available for histological evaluation. The macroscopic and microscopic features of unruptured intracerebral aneurysms with and without enhancement were assessed. The microscopic features studied included inflammatory cell invasion and vasa vasorum, which were assessed using immunohistochemical staining with CD68, CD3, CD20, and myeloperoxidase for the former and CD34 for the latter. A total of 21 (51.2%) aneurysms showed AWE (partial AWE, n=7; circumferential AWE, n=14). Atherosclerotic and translucent aneurysms were identified in 17 and 14 aneurysms, respectively. Aneurysm size, irregularity, and atherosclerotic and translucent aneurysms were associated with AWE on univariate analysis (P<0.05). Multivariate logistic regression analysis showed that atherosclerosis was the only factor significantly and independently associated with AWE (P=0.027). Histological assessment revealed that inflammatory cell infiltration, intraluminal thrombus, and vasa vasorum were significantly associated with AWE (P<0.05). Conclusions Though AWE on vessel wall magnetic resonance imaging scans may be associated with the presence of atherosclerotic lesions in unruptured intracerebral aneurysms, inflammatory cell infiltration within atherosclerosis, intraluminal thrombus, and vasa vasorum may be the main pathological features associated with AWE. However, the underlying pathological mechanism for AWE still needs to be further studied.

【 授权许可】

Unknown