Risk factors for the rupture of mirror middle cerebral artery aneurysm using computer-assisted semiautomated measurement and hemodynamic analysis

• Published in: Journal of stroke and cerebrovascular diseases 2022-12, Vol.31 (12), p.106841-106841, Article 106841
• Main Authors: Hu, Sheng-Qi, Chen, Ru-Dong, Xu, Wei-Dong, Yu, Jia-Sheng
• Format: Article
• Language: English
• Subjects: Aneurysm size; Middle cerebral artery; Mirror aneurysm; Neck diameter; Oscillatory shear index; Risk factors
• ISSN: 1052-3057; 1532-8511
• DOI: 10.1016/j.jstrokecerebrovasdis.2022.106841

•Mirror MCA aneurysms are rare but could avoid the patient-related factors and selection bias.•We use computer-assisted semiautomated measurement (CASAM) to measure the morphologic parameters more precisely. We also used computational fluid dynamics (CFD).•The size, neck diameter and maximum oscillatory shear index was independently significant and emphasized in the study. To identify the morphologic and hemodynamic risk factor of mirror middle cerebral artery (MCA) aneurysms. We conducted a retrospective analysis of 40 paired mirror MCA aneurysms. Aneurysms were divided into ruptured and unruptured groups. Seventeen morphological and nine hemodynamic parameters were measured using computer-assisted semiautomated measurement (CASAM) and computer flow dynamic (CFD) simulation. We performed a paired t-test (for normally distributed data) or a paired Wilcoxon rank-sum (for non-normally distributed data) to analyze all parameters between the groups. Multivariate conditional logistic regression analysis identified independent risk factors. The receiver operating characteristic curve was analyzed to acquire the area under the curve (AUC) and the cutoff values of the independent risk factors. There were significant differences in morphological and hemodynamic parameters between the ruptured and unruptured mirror aneurysms. The multivariate logistic analysis showed that the greater size (odds ratio [OR] = 9.807, p = 0.003), smaller neck diameter (OR = 0.285, p = 0.018) and maximum oscillatory shear index (OSI) (OR = 0.000001, p = 0.046) were independently correlated with aneurysm rupture. AUCs for size, N. and maximum OSI were 0.794, 0.695, and 0.701, respectively. The cutoff values of the size, neck diameter, and maximum OSI were 6.30, 5.07, and 0.356437, respectively. Morphology and hemodynamics can help predict aneurysm rupture risks. The more significant size, smaller neck diameter and maximum OSI were independent risk factors for the rupture of MCA aneurysms. The variables could aid practical risk evaluation.