The Association Between Aneurysm Wall Enhancement In Vessel-wall Magnetic Resonance Imaging And The Risk Factors Of Rupture And Related Characteristics With Unruptured Saccular Intracranial Aneurysm:meta-analysis

Objective: Unruptured intracranial aneurysm(UIA)have a high prevalence and their rupture is associated with considerable morbidity and mortality.There are observations in the characterization of aneurysm wall enhancement(AWE)as a biomarker of aneurysm wall inflammation and atherosclerosis.However,there is limited conclusive evidence on whether the AWE can be used as a marker of atherosclerosis and the risk factors of aneurysm rupture.We conducted this systematic review and meta-analysis to evaluate which risk factor of rupture is associated with the presence of AWE of UIA,to determine whether the AWE can be used as a marker of atherosclerosis and the risk factors of aneurysm rupture.Methods: The PUBMED,EMBASE,and Web of Science were searched for studies reporting the association between vessel-wall MRI of intracranial aneurysm and risk factor of rupture.According to the risk factors and related characteristics of UIA,whether there is AWE or not was grouped and analyzed.We performed meta-analysis using a randomeffects model.Study heterogeneity was assessed by using the Cochrane Q and I2 statistic,and publication bias was examined by using the Egger test.Potential origins of bias were detected by performing sensitivity analysis.All statistical analyses were performed using STATA version 12.0(STATA,College Station,TX).Result:Eleven studies were included in this review.We found a significant association between aspect radio(SMD,0.53;95% CI,0.10–0.97),irregular shape(OR,2.19;95% CI,1.38–3.47),and aneurysm size(OR,1.69;95% CI,0.87–2.52)and the presence of AWE.However,no significant difference was found in age(OR,-0.11;95% CI,-0.57–0.36),hypertension(OR,1.12;95% CI,0.83–1.53).,diabetes mellitus(OR,1.26;95% CI,0.44–3.60),multiple aneurysms(OR,0.71;95% CI,0.45–1.11),female sex(OR,1.00;95% CI,0.76–1.32),cigarette smoking(OR,0.97;95% CI,0.60–1.58)and the presence of AWE.Conclusion: Based on current evidence,it was found that the AWE might be the MRI manifestation of severe atherosclerosis of aneurysm wall.In addition,the enhancement of aneurysm wall could not be used as an independent risk factor for aneurysm rupture.