Computer-aided assessment of intracranial arterial tortuosity as a predictor of aneurysm occurrence and instability.

Purpose: To evaluate the associations between computer-aided multi-parametric tortuosity indexes and the occurrence and instability of intracranial aneurysms (IAs), and to explore the independence of these associations. Methods: A retrospective analysis was conducted on 705 patients (female: 64.1%,...

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Published in:Neuroradiology Vol. 68; no. 4; pp. 997 - 1007
Main Authors: Zeng, Li, Zhou, Pengyu, Zhang, Xiaolan, Zhao, Liming, Yang, Zhiwen, Wang, Yuting
Format: diagnostic images research tables/charts Journal Article
Published: Springer Nature Apr2026
Online Access:View this record in EBSCOhost
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      dt: Apr2026
      vid: 68
      iid: 4
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      pub: Springer Nature
      place: New York, New York
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        10.1007/s00234-026-03913-0
        193494965
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        atl: Computer-aided assessment of intracranial arterial tortuosity as a predictor of aneurysm occurrence and instability.
      aug:
        au:
          Zeng, Li
          Zhou, Pengyu
          Zhang, Xiaolan
          Zhao, Liming
          Yang, Zhiwen
          Wang, Yuting
        affil: https://ror.org/0014a0n68 Department of Radiology, The Affiliated Hospital of Southwest Medical University, Luzhou, China
      sug:
        subj:
          Intracranial Arterial Diseases Radiography
          Cerebral Aneurysm Risk Factors
          Computed Tomography Angiography
          Image Processing, Computer Assisted
          Human
          Retrospective Design
          Male
          Female
          Middle Age
          Aged
          Middle Cerebral Artery
          Univariate Statistics
          Multivariate Analysis
          T-Tests
          Mann-Whitney U Test
          Wilcoxon Rank Sum Test
          Chi Square Test
          Spearman's Rank Correlation Coefficient
          Post Hoc Analysis
          Data Analysis Software
          Funding Source
          Middle Aged: 45-64 years
          Aged: 65+ years
          Male
          Female
      ab: Purpose: To evaluate the associations between computer-aided multi-parametric tortuosity indexes and the occurrence and instability of intracranial aneurysms (IAs), and to explore the independence of these associations. Methods: A retrospective analysis was conducted on 705 patients (female: 64.1%, age: 58.58 ± 11.69) who underwent intracranial Computed Tomography Angiography, comprising 235 unstable aneurysm patients, 235 stable aneurysm patients, and 235 healthy controls. Computer-aided analysis quantified relative length (RL), triangular index (TI), and mean curvature (κmean) in bilateral internal carotid arteries (ICAs) and middle cerebral arteries (MCAs). Univariate analysis compared tortuosity parameters within/between groups, and multivariate analysis evaluated independence. Results: Compared with the non-aneurysm side, the ICA aneurysm-bearing side had a higher TI (p = 0.005) at the C6, and a higher RL (p = 0.004), TI (p = 0.003), and κmean (p = 0.009) at the C7. Compared with the healthy arteries from control subjects, the C6 of the ICA aneurysm-bearing arteries had higher κmean (p = 0.002), the C7 had higher TI (p < 0.001) and κmean (p < 0.001), aneurysm-bearing MCAs had higher TI (p < 0.001) and κmean (p = 0.004). Compared with arteries with stable aneurysms, the aneurysm-bearing ICAs in the unstable group had higher TI (p = 0.001) and κmean (p = 0.039), and the aneurysm-bearing MCAs had higher TI (p = 0.044). Multivariate analysis showed that TI (p < 0.001, OR = 4.63) was an independent risk factor for ICA aneurysm instability. Conclusions: Increased intracranial arterial tortuosity is associated with the occurrence and instability of IAs. TI of the aneurysm-bearing arteries is an independent risk factor for the instability of ICA aneurysms. TI tends to have a higher sensitivity than RL.
      pubtype: Academic Journal
      doctype:
        diagnostic images
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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