• Liuxun Hu, Kai Quan, Yuan Shi, Peixi Liu, Jianping Song, Yanlong Tian, Qingzhu An, Yingjun Liu, Sichen Li, Guo Yu, Zhiyuan Fan, Jianfeng Luo, Yuxiang Gu, Bin Xu, Wei Zhu, and Ying Mao.
• Department of Neurosurgery, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, China.
• Neurosurgery. 2023 Feb 1; 92 (2): 421430421-430.

BackgroundMR vascular wall imaging (VWI) may have prognostic value in patients with unruptured intracranial aneurysms (UIAs).ObjectiveTo evaluate the value of VWI as a predictor of surgical outcome in patients with UIAs.MethodsThis prospective cohort study evaluated surgical outcomes in consecutive patients with UIAs who underwent surgical clipping at a single center. All participants underwent high-resolution VWI and were followed for at least 6 months. The primary clinical outcome was modified Rankin scale (mRS) score 6 months after surgery.ResultsThe number of patients in the no wall enhancement, uniform wall enhancement (UWE), and focal wall enhancement (FWE) groups was 37, 145, and 154, respectively. Incidence of postoperative complications was 15.5% in the FWE group, 12.4% in the UWE group, and 5.4% in the no wall enhancement group. The proportion of patients with mRS score >2 at the 6-month follow-up was significantly higher in the FWE group than in the UWE group (14.3% vs 6.9%; P = .0389). In the multivariate analysis, FWE (odds ratio, 2.573; 95% CI 1.001-6.612) and positive proximal artery remodeling (odds ratio, 10.56; 95% CI 2.237-49.83) were independent predictors of mRS score >2 at the 6-month follow-up.ConclusionPreoperative VWI can improve the surgeon's understanding of aneurysm pathological structure. Type of aneurysmal wall enhancement on VWI is associated with clinical outcome and incidence of salvage anastomosis and surgical complications.Copyright © Congress of Neurological Surgeons 2022. All rights reserved.

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