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- Title
Systemic immune-inflammation index is associated with aneurysmal wall enhancement in unruptured intracranial fusiform aneurysms.
- Authors
Fei Peng; Jiaxiang Xia; Hao Niu; Xin Feng; Tianheng Zheng; Xiaoxin He; Boya Xu; Xuge Chen; Peng Xu; Hong Zhang; Jigang Chen; Xin Tong; Xiaoyan Bai; Zhiye Li; Yonghong Duan; Binbin Sui; Xingquan Zhao; Aihua Liu
- Abstract
Introduction: Inflammation plays a key role in the progression of intracranial aneurysms. Aneurysmal wall enhancement (AWE) correlates well with inflammatory processes in the aneurysmal wall. Understanding the potential associations between blood inflammatory indices and AWE may aid in the further understanding of intracranial aneurysm pathophysiology. Methods: We retrospectively reviewed 122 patients with intracranial fusiform aneurysms (IFAs) who underwent both high-resolution magnetic resonance imaging and blood laboratory tests. AWE was defined as a contrast ratio of the signal intensity of the aneurysmal wall to that of the pituitary stalk = 0.90. The systemic immune-inflammation (SII) index (neutrophils × platelets/lymphocytes) was calculated from laboratory data and dichotomized based on whether or not the IFA had AWE. Aneurysmal symptoms were defined as sentinel headache or oculomotor nerve palsy. Multivariable logistic regression and receiver operating characteristic curve analyses were performed to determine how well the SII index was able to predict AWE and aneurysmal symptoms. Spearman's correlation coefficients were used to explore the potential associations between variables. Results: This study included 95 patients, of whom 24 (25.3%) presented with AWE. After adjusting for baseline differences in neutrophil to lymphocyte ratios, leukocytes, and neutrophils in the multivariable logistic regression analysis, smoking history (P = 0.002), aneurysmal symptoms (P = 0.047), maximum diameter (P = 0.048), and SII index (P = 0.022) all predicted AWE. The SII index (P = 0.038) was the only independent predictor of aneurysmal symptoms. The receiver operating characteristic curve analysis revealed that the SII index was able to accurately distinguish IFAs with AWE (area under the curve = 0.746) and aneurysmal symptoms (area under the curve = 0.739). Discussion: An early elevation in the SII index can independently predict AWE in IFAs and is a potential new biomarker for predicting IFA instability.
- Subjects
INTRACRANIAL aneurysms; RECEIVER operating characteristic curves; NEUTROPHIL lymphocyte ratio; MAGNETIC resonance imaging; OCULOMOTOR nerve; LOGISTIC regression analysis
- Publication
Frontiers in Immunology, 2023, Vol 13, p1
- ISSN
1664-3224
- Publication type
Article
- DOI
10.3389/fimmu.2023.1106459