Vessel wall imaging helping to identify dangerous brain aneurysms

Published: Dec. 2, 2020 at 8:19 AM EST
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As many as six and a half million people in the United States, or one in 50 people, have unruptured brain aneurysms and don’t know it! People with aneurysms often have no symptoms unless the aneurysm bursts, which can be life-threatening. Researchers are now looking at a new technique that could highlight aneurysms with a higher potential for rupture.

This is what doctors see when diagnosing a brain aneurysm, a balloon or bulge in vessels. But which aneurysms need treatment, and which will be harmless? Yale neurovascular surgeon Charles Matouk and colleagues are testing a new imaging technique that allows them to examine the vessel wall. First, a patient gets an MRI scan, then he receives an IV injection in his hand of a special dye. Then, the patient is scanned again.

Charles Matouk, MD, vice chair of clinical affairs for the department of neurosurgery and chief of neurovascular surgery at Yale School of Medicine explains, “So that dye that you’re injecting, in an IV, in your hand, will get picked up in the wall of this very tiny, two or three-millimeter aneurysm.”

Dr. Matouk says an aneurysm that has bled will light up on the scan almost like it has a halo around it. Because most small aneurysms don’t bleed, if an aneurysm does not light up, immediate treatment might not be necessary.

“The implication is that if we don’t see enhancement and the aneurysm is small, and most small aneurysms don’t bleed, then maybe those are aneurysms that can be safely watched,” described Dr. Matouk.

Eliminating the need for immediate brain surgery.

The Yale team says the MRI imaging they are using has a 3-Tesla magnet which is a stronger magnet, but it’s still a system that is available at most hospitals across the US. So, the technique can be made widely available.

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