Both aneurysm wall enhancement (AWE) and irregular pulsation have been suggested as potential candidates for intracranial aneurysms (IAs) instability. No studies have explored the association between AWE and irregular pulsation. By using vessel wall MRI and four-dimensional computed tomography angiography, we found a significantly strong correlation between AWE and irregular pulsation (phi coefficient=0.569, p<0.001). IAs with irregular pulsation had much less AWE grade 0 and more AWE grade 1, 2 and 3 compared with IAs without irregular pulsation (all p<0.05). Further longitudinal studies are needed to validate the role of the two imaging markers in predicting aneurysm growth and rupture.
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