Volumetric Artificial Intelligence Analysis of Prerupture and Postrupture Cerebral Aneurysms: Assessment of Morphologic Change.

Background: Cerebral aneurysm rupture is a major cause of potential years of life lost. Research on rupture risk has often compared unruptured and ruptured aneurysms, with the implicit assumption that the rupture event does not significantly change aneurysm morphology. However, aneurysm morphology is charged by rupture, although precisely how remains a matter of debate.

Methods: We used a semiautomated artificial intelligence volumetric aneurysm analysis tool to study prerupture and postrupture aneurysms (n = 6). Aneurysms were assessed quantitatively with conventional linear measurements as well as by using volume and surface area. Qualitative side-by-side and superimposed volumetric analysis was performed to assess the likely point of rupture.

Results: The morphologic changes as measured using linear measurement showed both increases and decreases in size for maximum dimension, dome height, dome width, and neck width. However, volume increased in all cases, by a minimum of 11% (range, 11%-47%). In all cases, the point of rupture was clear from coregistration or side-by-side three-dimensional volumetric comparison.

Conclusions: All aneurysms in our cohort increased substantially in volume after rupture when measured with a semiautomated artificial intelligence volumetric measurement tool. However, linear measurements showed both increases and decreases in size. The rupture site was easy to detect in all cases by qualitative volumetric assessment.