High-Resolution Magnetic Resonance Imaging (HR-MRI) Evaluation of the Distribution and Characteristics of Intra-Aneurysm Thrombosis to Improve Clinical Diagnosis of Thrombotic Intracranial Aneurysm

BACKGROUND: We aimed to analyze the related factors of intracranial anterior circulation saccular artery thrombosis and its characteristics on high-resolution magnetic resonance imaging (HR-MRI) images to provide a basis for neurosurgeons to select the precise treatment strategy for thrombotic intracranial aneurysms (TIA). MATERIAL/METHODS: This retrospective analysis included 136 patients with unruptured intracranial anterior circulation artery aneurysms who underwent HR-MRI. The 136 aneurysms were divided into thrombus (41) and non-thrombus (95) groups. Single factor analysis of morphological and clinical indicators were conducted to select meaningful indicators for logistic regression analysis; the optimal diagnostic threshold was calculated through ROC curve analysis. The location and signal characteristics of thrombi were analyzed to inform clinical treatment. RESULTS: Single factor analysis revealed significant differences in patient age, aneurysm size, aneurysm neck, aspect ratio, size ratio, and hyperlipidemia between the 2 groups (P<0.05). Multi-factor regression analysis demonstrated that aneurysm size (OR=2.180) and aspect ratio value (OR=7.495) were correlated with intracranial thrombosis. ROC curve analysis showed that for aneurysms larger than 8 mm, the sensitivity and specificity of TIA prediction were 83% and 93%, respectively. For aneurysms with aspect ratio values greater than 2.5, sensitivity and specificity of TIA predication were 75% and 95%, respectively. The proportion of aneurysm wall enhancement and clinical symptoms in the thrombus group was significantly higher than that in the non-thrombus group. CONCLUSIONS: Intracranial unruptured aneurysms with the size larger than 8 mm or with aspect ratio values higher than 2.5 indicated the possible formation of thrombosis in the aneurysm.