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Peer-reviewedCC BYAJNR: American Journal of Neuroradiology

Quantitative MRA Feature Prediction of Postaneurysmal Subarachnoid Hemorrhage Delayed Cerebral Ischemia and Angiographic Vasospasm

  • Mohamad H. Mosi1
  • Mona Kharaji1
  • Mehmet Aksakal1,2
  • Kaiyu Zhang3
  • Charles Watt1
  • Dan Cheng1
  • Michael R. Levitt1,4,5
  • Gador Canton1
  • Chun Yuan1
  • Niranjan Balu1
  • Mahmud Mossa-Basha1,6
6 affiliations
  1. 1From the Department of Radiology (M.H.M., M.K., M.A., C.W., D.C., M.R.L., G.C., C.Y., N.B., M.M.-B.), University of Washington, Seattle, Washington
  2. 2Department of Radiology (M.A.), University of Colorado, Aurora, Colorado
  3. 3Department of Bioengineering (K.Z.), University of Washington, Seattle, Washington
  4. 4Department of Neurosurgery (M.R.L.), University of Washington, Seattle, Washington
  5. 5Department of Mechanical Engineering (M.R.L.), University of Washington, Seattle, Washington
  6. 6Department of Radiology (M.M.-B.), University of Alabama at Birmingham, Birmingham, Alabama
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Abstract

BACKGROUND AND PURPOSE: Complications of aneurysmal SAH (aSAH), including vasospasm and delayed cerebral ischemia (DCI), substantially contribute to morbidity and mortality. We investigated the correlation between quantitative measurements on MRA performed immediately after endovascular embolization and subsequent development of DCI or vasospasm. MATERIALS AND METHODS: We included consecutive patients scanned between September 1, 2016 and January 14, 2022 with ruptured intracranial aneurysms (IAs) after endovascular treatment. We recorded clinical data including sex, age, body mass index (BMI), smoking history, vascular risk factors, baseline CTA/CT features, modified Fisher score, and Glasgow Coma Score. We extracted quantitative MRA features, including total arterial length, total branch number, and average tortuosity, using a custom semiautomated software (VesselVoyager). Correlations among baseline quantitative MRA and other imaging and clinical features with DCI and vasospasm were determined using logistic regression analysis. Receiver operating characteristic (ROC) curves were calculated for clinical-only models and for models augmented with quantitative MRA features. RESULTS: = .02) were independently associated with vasospasm incidence on multivariable regression. Adding quantitative MRA features improved ROC performance for both DCI (area under the receiver operating characteristic curve 0.63 [95% CI, 0.51-0.75]) vs 0.75 [95% CI, 0.64-0.87]) and vasospasm (area under the receiver operating characteristic curve 0.67 [95% CI, 0.54-0.79] vs 0.85 [95% CI, 0.77-0.94]). CONCLUSIONS: In patients with aSAH, average tortuosity is independently inversely associated with future development of DCI. Total branch number and average tortuosity are independently inversely associated with future vasospasm. With further validation, quantitative MRA features may serve as predictive markers for DCI and vasospasm after aSAH.

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Cite

BibTeXRIS
BibTeX
@article{mosi2026quantitative,
  title = {{Quantitative MRA Feature Prediction of Postaneurysmal Subarachnoid Hemorrhage Delayed Cerebral Ischemia and Angiographic Vasospasm}},
  author = {Mohamad H. Mosi and Mona Kharaji and Mehmet Aksakal and Kaiyu Zhang and Charles Watt and Dan Cheng and Michael R. Levitt and Gador Canton and Chun Yuan and Niranjan Balu and Mahmud Mossa-Basha},
  journal = {AJNR: American Journal of Neuroradiology},
  year = {2026},
  month = nov,
  doi = {10.3174/ajnr.a9303},
  url = {https://doi.org/10.3174/ajnr.a9303},
  note = {CC BY},
}
RIS
TY  - JOUR
TI  - Quantitative MRA Feature Prediction of Postaneurysmal Subarachnoid Hemorrhage Delayed Cerebral Ischemia and Angiographic Vasospasm
AU  - Mohamad H. Mosi
AU  - Mona Kharaji
AU  - Mehmet Aksakal
AU  - Kaiyu Zhang
AU  - Charles Watt
AU  - Dan Cheng
AU  - Michael R. Levitt
AU  - Gador Canton
AU  - Chun Yuan
AU  - Niranjan Balu
AU  - Mahmud Mossa-Basha
PY  - 2026
DA  - 2026/11/06
JO  - AJNR: American Journal of Neuroradiology
DO  - 10.3174/ajnr.a9303
UR  - https://doi.org/10.3174/ajnr.a9303
AB  - BACKGROUND AND PURPOSE: Complications of aneurysmal SAH (aSAH), including vasospasm and delayed cerebral ischemia (DCI), substantially contribute to morbidity and mortality. We investigated the correlation between quantitative measurements on MRA performed immediately after endovascular embolization and subsequent development of DCI or vasospasm. MATERIALS AND METHODS: We included consecutive patients scanned between September 1, 2016 and January 14, 2022 with ruptured intracranial aneurysms (IAs) after endovascular treatment. We recorded clinical data including sex, age, body mass index (BMI), smoking history, vascular risk factors, baseline CTA/CT features, modified Fisher score, and Glasgow Coma Score. We extracted quantitative MRA features, including total arterial length, total branch number, and average tortuosity, using a custom semiautomated software (VesselVoyager). Correlations among baseline quantitative MRA and other imaging and clinical features with DCI and vasospasm were determined using logistic regression analysis. Receiver operating characteristic (ROC) curves were calculated for clinical-only models and for models augmented with quantitative MRA features. RESULTS: = .02) were independently associated with vasospasm incidence on multivariable regression. Adding quantitative MRA features improved ROC performance for both DCI (area under the receiver operating characteristic curve 0.63 [95% CI, 0.51-0.75]) vs 0.75 [95% CI, 0.64-0.87]) and vasospasm (area under the receiver operating characteristic curve 0.67 [95% CI, 0.54-0.79] vs 0.85 [95% CI, 0.77-0.94]). CONCLUSIONS: In patients with aSAH, average tortuosity is independently inversely associated with future development of DCI. Total branch number and average tortuosity are independently inversely associated with future vasospasm. With further validation, quantitative MRA features may serve as predictive markers for DCI and vasospasm after aSAH.
SN  - 0195-6108
SN  - 1936-959X
ER  -