Comparative Morphological Analysis of the Geometry of Ruptured and Unruptured Aneurysms

Neurosurgery 69:349–356, 2011 DOI: 10.1227/NEU.0b013e31821661c3

The risk of aneurysm rupture appears to be related to multiple factors such as topology, morphology, size, perianeurysmal environment, and blood flow hemodynamics.

OBJECTIVE: To evaluate aneurysm morphology and to quantitatively compare the volumetric parameters between ruptured and unruptured aneurysms from our clinical database at the UCLA Medical Center.

METHODS: Novel algorithms that automatically compute aneurysm geometry were tested on the basis of voxel data obtained from angiographic images, and measurements of aneurysm morphology were automatically recorded. We studied a total of 50 aneurysms (25 ruptured and 25 unruptured) with sizes ranging from 3 to 26 mm. To compare the geometric characteristics between ruptured and unruptured groups, we examined measurements, including volume and surface area, and the ratios of these measurements to the minimal bounding sphere around each aneurysm.

RESULTS: More than 65% of ruptured aneurysms had a ratio of aneurysm volume to bounding sphere volume (AVSV) of > 0.5. More than 70% of ruptured aneurysms had a ratio of aneurysm surface to bounding sphere surface (AASA) of < 1. A trend differentiating ruptured and unruptured aneurysms was observed in AVSV (P = .07) and AASA (P = .04). Classification and regression trees analysis showed 68% correct classification with rupture for AVSV and 70% for AASA.

CONCLUSION: By comparing aneurysm geometry with the bounding sphere, we found a trend associating the ratios of aneurysm volume and surface area with rupture. These geometric parameters may be useful for understanding the influence of morphology on the risk of aneurysm rupture.