Abstract
Objective
ELAPSS score is commonly utilized for predicting growth of unruptured cerebral aneurysms. However, its application is unsuitable for small aneurysms with high demand for growth prediction. Consequently, we investigated the diagnostic accuracy of semi-quantitative assessment using the ELAPSS score and hemodynamic parameters using computational fluid dynamics (CFD) in small aneurysms.
Methods
A prospective observational study from January 2013 to February 2022 included 185 patients with 215 unruptured aneurysms with a maximum diameter of 3–5 mm. Aneurysms were classified into stable (186 aneurysms) and growth (29 aneurysms) groups based on repeated images. We calculated high shear area ratios (HSAR), high shear concentration ratio (HSCR), and flow concentration ratio (FCR) as hemodynamic parameters that we have already reported to be associated with small aneurysm growth in our previous study. The characteristics associated with the growth of small aneurysms were statistically investigated with morphological variables and hemodynamic parameters. The ELAPSS score was also calculated for the same aneurysm group to determine whether the growth risk was sufficiently assessed.
Results
In morphological variables, no significant differences were observed between the two groups. As for the hemodynamic parameters, the growth group had significantly lower FCR (0.61 vs 0.66, p = 0.016), lower HSAR (0.28 vs 0.33, p < 0.001), and higher HSCR (6.39 vs 5.01, p < 0.001). However, there were no significant differences in the ELAPSS scores between the two groups.
Conclusions
CFD may offer more enhanced predictive capabilities compared to the ELAPSS score for identifying growth tendencies in small aneurysms.