Combination of irregular pulsation and aneurysm wall enhancement improved the diagnostic efficiency of symptomatic intracranial aneurysm

Both aneurysm wall enhancement (AWE) and irregular pulsation have been suggested as potential candidates for intracranial aneurysms (IAs) instability. However, no studies have compared irregular pulsation and AWE for evaluation symptoms in unruptured IAs. By using vessel wall MRI and four-dimensional computed tomography angiography, we found combination of aneurysm wall enhancement and irregular pulsation improve the diagnostic efficiency of symptomatic intracranial aneurysm compared with irregular pulsation or AWE alone. Further longitudinal studies are needed to validate the role of the two imaging markers in predicting aneurysm growth and rupture.