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<meta name="DC.Language" content="en" />
<meta name="DC.Title" content="Novel Models for Identification of the Ruptured Aneurysm in Patients with Subarachnoid Hemorrhage with Multiple Aneurysms" />
<meta name="DC.Identifier" content="10.3174/ajnr.A6259" />
<meta name="DC.Date" content="2019-11-01" />
<meta name="DC.Publisher" content="American Journal of Neuroradiology" />
<meta name="DC.Rights" content="© 2019 by American Journal of Neuroradiology. Indicates open access to non-subscribers at www.ajnr.org" />
<meta name="DC.AccessRights" content="open-access" />
<meta name="DC.Description" content="BACKGROUND AND PURPOSE: In patients with SAH with multiple intracranial aneurysms, often the hemorrhage pattern does not indicate the rupture source. Angiographic findings (intracranial aneurysm size and shape) could help but may not be reliable. Our purpose was to test whether existing parameters could identify the ruptured intracranial aneurysm in patients with multiple intracranial aneurysms and whether composite predictive models could improve the identification.

MATERIALS AND METHODS: We retrospectively collected angiographic and medical records of 93 patients with SAH with at least 2 intracranial aneurysms (total of 206 saccular intracranial aneurysms, 93 ruptured), in which the ruptured intracranial aneurysm was confirmed through surgery or definitive hemorrhage patterns. We calculated 13 morphologic and 10 hemodynamic parameters along with location and type (sidewall/bifurcation) and tested their ability to identify rupture in the 93 patients. To build predictive models, we randomly assigned 70 patients to training and 23 to holdout testing cohorts. Using a linear regression model with a customized cost function and 10-fold cross-validation, we trained 2 rupture identification models: RIMC using all parameters and RIMM excluding hemodynamics.

RESULTS: The 25 study parameters had vastly different positive predictive values (31%–87%) for identifying rupture, the highest being size ratio at 87%. RIMC incorporated size ratio, undulation index, relative residence time, and type; RIMM had only size ratio, undulation index, and type. During cross-validation, positive predictive values for size ratio, RIMM, and RIMC were 86% ± 4%, 90% ± 4%, and 93% ± 4%, respectively. In testing, size ratio and RIMM had positive predictive values of 85%, while RIMC had 92%.

CONCLUSIONS: Size ratio was the best individual factor for identifying the ruptured aneurysm; however, RIMC, followed by RIMM, outperformed existing parameters.

AR
:   aspect ratio
CFD
:   computational fluid dynamics
D
:   maximum diameter
H
:   height (perpendicular)
Hmax
:   maximum height
IA
:   intracranial aneurysm
NWSS
:   normalized wall shear stress
OSI
:   oscillatory shear index
RIM
:   rupture identification model
RRS
:   rupture resemblance score
RRT
:   relative residence time
SR
:   size ratio
UI
:   undulation index
WSS
:   wall shear stress" />
<meta name="DC.Contributor" content="H. Rajabzadeh-Oghaz" />
<meta name="DC.Contributor" content="J. Wang" />
<meta name="DC.Contributor" content="N. Varble" />
<meta name="DC.Contributor" content="S.-I. Sugiyama" />
<meta name="DC.Contributor" content="A. Shimizu" />
<meta name="DC.Contributor" content="L. Jing" />
<meta name="DC.Contributor" content="J. Liu" />
<meta name="DC.Contributor" content="X. Yang" />
<meta name="DC.Contributor" content="A.H. Siddiqui" />
<meta name="DC.Contributor" content="J.M. Davies" />
<meta name="DC.Contributor" content="H. Meng" />
<meta name="article:published_time" content="2019-11-01" />
<meta name="article:section" content="Interventional" />
<meta name="citation_title" content="Novel Models for Identification of the Ruptured Aneurysm in Patients with Subarachnoid Hemorrhage with Multiple Aneurysms" />
<meta name="citation_abstract" lang="en" content="&lt;h3&gt;BACKGROUND AND PURPOSE:&lt;/h3&gt;
&lt;p&gt;In patients with SAH with multiple intracranial aneurysms, often the hemorrhage pattern does not indicate the rupture source. Angiographic findings (intracranial aneurysm size and shape) could help but may not be reliable. Our purpose was to test whether existing parameters could identify the ruptured intracranial aneurysm in patients with multiple intracranial aneurysms and whether composite predictive models could improve the identification.&lt;/p&gt;&lt;h3&gt;MATERIALS AND METHODS:&lt;/h3&gt;
&lt;p&gt;We retrospectively collected angiographic and medical records of 93 patients with SAH with at least 2 intracranial aneurysms (total of 206 saccular intracranial aneurysms, 93 ruptured), in which the ruptured intracranial aneurysm was confirmed through surgery or definitive hemorrhage patterns. We calculated 13 morphologic and 10 hemodynamic parameters along with location and type (sidewall/bifurcation) and tested their ability to identify rupture in the 93 patients. To build predictive models, we randomly assigned 70 patients to training and 23 to holdout testing cohorts. Using a linear regression model with a customized cost function and 10-fold cross-validation, we trained 2 rupture identification models: RIM&lt;sub&gt;C&lt;/sub&gt; using all parameters and RIM&lt;sub&gt;M&lt;/sub&gt; excluding hemodynamics.&lt;/p&gt;&lt;h3&gt;RESULTS:&lt;/h3&gt;
&lt;p&gt;The 25 study parameters had vastly different positive predictive values (31%–87%) for identifying rupture, the highest being size ratio at 87%. RIM&lt;sub&gt;C&lt;/sub&gt; incorporated size ratio, undulation index, relative residence time, and type; RIM&lt;sub&gt;M&lt;/sub&gt; had only size ratio, undulation index, and type. During cross-validation, positive predictive values for size ratio, RIM&lt;sub&gt;M&lt;/sub&gt;, and RIM&lt;sub&gt;C&lt;/sub&gt; were 86% ± 4%, 90% ± 4%, and 93% ± 4%, respectively. In testing, size ratio and RIM&lt;sub&gt;M&lt;/sub&gt; had positive predictive values of 85%, while RIM&lt;sub&gt;C&lt;/sub&gt; had 92%.&lt;/p&gt;&lt;h3&gt;CONCLUSIONS:&lt;/h3&gt;
&lt;p&gt;Size ratio was the best individual factor for identifying the ruptured aneurysm; however, RIM&lt;sub&gt;C&lt;/sub&gt;, followed by RIM&lt;sub&gt;M&lt;/sub&gt;, outperformed existing parameters.&lt;/p&gt;" />
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<meta name="twitter:title" content="Novel Models for Identification of the Ruptured Aneurysm in Patients with Subarachnoid Hemorrhage with Multiple Aneurysms" />
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<meta name="twitter:description" content="BACKGROUND AND PURPOSE: In patients with SAH with multiple intracranial aneurysms, often the hemorrhage pattern does not indicate the rupture source. Angiographic findings (intracranial aneurysm size and shape) could help but may not be reliable. Our purpose was to test whether existing parameters could identify the ruptured intracranial aneurysm in patients with multiple intracranial aneurysms and whether composite predictive models could improve the identification.

MATERIALS AND METHODS: We retrospectively collected angiographic and medical records of 93 patients with SAH with at least 2 intracranial aneurysms (total of 206 saccular intracranial aneurysms, 93 ruptured), in which the ruptured intracranial aneurysm was confirmed through surgery or definitive hemorrhage patterns. We calculated 13 morphologic and 10 hemodynamic parameters along with location and type (sidewall/bifurcation) and tested their ability to identify rupture in the 93 patients. To build predictive models, we randomly assigned 70 patients to training and 23 to holdout testing cohorts. Using a linear regression model with a customized cost function and 10-fold cross-validation, we trained 2 rupture identification models: RIMC using all parameters and RIMM excluding hemodynamics.

RESULTS: The 25 study parameters had vastly different positive predictive values (31%–87%) for identifying rupture, the highest being size ratio at 87%. RIMC incorporated size ratio, undulation index, relative residence time, and type; RIMM had only size ratio, undulation index, and type. During cross-validation, positive predictive values for size ratio, RIMM, and RIMC were 86% ± 4%, 90% ± 4%, and 93% ± 4%, respectively. In testing, size ratio and RIMM had positive predictive values of 85%, while RIMC had 92%.

CONCLUSIONS: Size ratio was the best individual factor for identifying the ruptured aneurysm; however, RIMC, followed by RIMM, outperformed existing parameters.

AR
:   aspect ratio
CFD
:   computational fluid dynamics
D
:   maximum diameter
H
:   height (perpendicular)
Hmax
:   maximum height
IA
:   intracranial aneurysm
NWSS
:   normalized wall shear stress
OSI
:   oscillatory shear index
RIM
:   rupture identification model
RRS
:   rupture resemblance score
RRT
:   relative residence time
SR
:   size ratio
UI
:   undulation index
WSS
:   wall shear stress" />
<meta name="og-title" property="og:title" content="Novel Models for Identification of the Ruptured Aneurysm in Patients with Subarachnoid Hemorrhage with Multiple Aneurysms" />
<meta name="og-url" property="og:url" content="http://ajnr-stage2.stage.highwire.org/content/40/11/1939" />
<meta name="og-site-name" property="og:site_name" content="American Journal of Neuroradiology" />
<meta name="og-description" property="og:description" content="BACKGROUND AND PURPOSE: In patients with SAH with multiple intracranial aneurysms, often the hemorrhage pattern does not indicate the rupture source. Angiographic findings (intracranial aneurysm size and shape) could help but may not be reliable. Our purpose was to test whether existing parameters could identify the ruptured intracranial aneurysm in patients with multiple intracranial aneurysms and whether composite predictive models could improve the identification.

MATERIALS AND METHODS: We retrospectively collected angiographic and medical records of 93 patients with SAH with at least 2 intracranial aneurysms (total of 206 saccular intracranial aneurysms, 93 ruptured), in which the ruptured intracranial aneurysm was confirmed through surgery or definitive hemorrhage patterns. We calculated 13 morphologic and 10 hemodynamic parameters along with location and type (sidewall/bifurcation) and tested their ability to identify rupture in the 93 patients. To build predictive models, we randomly assigned 70 patients to training and 23 to holdout testing cohorts. Using a linear regression model with a customized cost function and 10-fold cross-validation, we trained 2 rupture identification models: RIMC using all parameters and RIMM excluding hemodynamics.

RESULTS: The 25 study parameters had vastly different positive predictive values (31%–87%) for identifying rupture, the highest being size ratio at 87%. RIMC incorporated size ratio, undulation index, relative residence time, and type; RIMM had only size ratio, undulation index, and type. During cross-validation, positive predictive values for size ratio, RIMM, and RIMC were 86% ± 4%, 90% ± 4%, and 93% ± 4%, respectively. In testing, size ratio and RIMM had positive predictive values of 85%, while RIMC had 92%.

CONCLUSIONS: Size ratio was the best individual factor for identifying the ruptured aneurysm; however, RIMC, followed by RIMM, outperformed existing parameters.

AR
:   aspect ratio
CFD
:   computational fluid dynamics
D
:   maximum diameter
H
:   height (perpendicular)
Hmax
:   maximum height
IA
:   intracranial aneurysm
NWSS
:   normalized wall shear stress
OSI
:   oscillatory shear index
RIM
:   rupture identification model
RRS
:   rupture resemblance score
RRT
:   relative residence time
SR
:   size ratio
UI
:   undulation index
WSS
:   wall shear stress" />
<meta name="og-type" property="og:type" content="article" />
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    <div class="highwire-article-citation highwire-citation-type-highwire-article node71288--7" data-node-nid="71288" id="top-node-71288--8874345342" data-pisa="ajnr;40/11/1939" data-pisa-master="ajnr;ajnr.A6259" data-apath="/ajnr/40/11/1939.atom" data-hw-author-tooltip-instance="highwire_author_tooltip"><div class="highwire-cite highwire-cite-highwire-article highwire-citation-jcore-article-title-complete clearfix has-author-tooltip highwire-citation-highwire-article-top-a">
  
  
      <div class="highwire-cite-overline"><span  class="highwire-cite-metadata-article-type highwire-cite-metadata">Research Article</span><span class="separator-pipe"></span><span  class="highwire-cite-metadata-art-cat highwire-cite-metadata"><span class="wrapper">Interventional</span></span></div>
  
      <div class="highwire-cite-access"><span class="highwire-citation-access"><i class="highwire-access-icon highwire-access-icon-open-access open-access hw-icon-open-access" title="Open Access" aria-hidden="true"></i><span  class="element-invisible highwire-access-icon highwire-access-icon-open-access" style="">Open Access</span></span></div>
  
      <h1 class="highwire-cite-title" id="page-title">Novel Models for Identification of the Ruptured Aneurysm in Patients with Subarachnoid Hemorrhage with Multiple Aneurysms</h1>  
    	<div class="highwire-cite-authors"><span  class="highwire-citation-authors"><span class="highwire-citation-author first" data-delta="0">H. Rajabzadeh-Oghaz</span>, <span class="highwire-citation-author" data-delta="1">J. Wang</span>, <span class="highwire-citation-author" data-delta="2">N. Varble</span>, <span class="highwire-citation-author" data-delta="3">S.-I. Sugiyama</span>, <span class="highwire-citation-author" data-delta="4">A. Shimizu</span>, <span class="highwire-citation-author" data-delta="5">L. Jing</span>, <span class="highwire-citation-author" data-delta="6">J. Liu</span>, <span class="highwire-citation-author" data-delta="7">X. Yang</span>, <span class="highwire-citation-author" data-delta="8">A.H. Siddiqui</span>, <span class="highwire-citation-author" data-delta="9">J.M. Davies</span> and <span class="highwire-citation-author" data-delta="10">H. Meng</span></span></div>
  
    	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-journal highwire-cite-metadata">American Journal of Neuroradiology </span><span  class="highwire-cite-metadata-date highwire-cite-metadata">November 2019,  </span><span  class="highwire-cite-metadata-volume highwire-cite-metadata">40 </span><span  class="highwire-cite-metadata-issue highwire-cite-metadata">(11) </span><span  class="highwire-cite-metadata-pages highwire-cite-metadata">1939-1946; </span><span  class="highwire-cite-metadata-doi highwire-cite-metadata">DOI: https://doi.org/10.3174/ajnr.A6259 </span></div>
  
  
  
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<div id="hw-article-author-popups-top-node-71288--8874345342" style="display: none;"><div class="author-tooltip-0"><div class="author-tooltip-name">H. Rajabzadeh-Oghaz </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>a</span>From the Canon Stroke and Vascular Research Center (H.R.-O., N.V., A.H.S., J.M.D., H.M.)</div><div class='author-affiliation'><span class='nlm-sup'>b</span>Departments of Mechanical and Aerospace Engineering (H.R.-O., N.V., H.M.)</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=H.%2BRajabzadeh-Oghaz%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Rajabzadeh-Oghaz%20H&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AH.%2BRajabzadeh-Oghaz%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="https://orcid.org/0000-0002-9138-9239" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for H. Rajabzadeh-Oghaz</a></li></ul></div><div class="author-tooltip-1"><div class="author-tooltip-name">J. Wang </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>c</span>Biostatistics (J.W.), University at Buffalo, Buffalo, New York</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=J.%2BWang%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Wang%20J&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AJ.%2BWang%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="https://orcid.org/0000-0002-2709-5332" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for J. Wang</a></li></ul></div><div class="author-tooltip-2"><div class="author-tooltip-name">N. Varble </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>a</span>From the Canon Stroke and Vascular Research Center (H.R.-O., N.V., A.H.S., J.M.D., H.M.)</div><div class='author-affiliation'><span class='nlm-sup'>b</span>Departments of Mechanical and Aerospace Engineering (H.R.-O., N.V., H.M.)</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=N.%2BVarble%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Varble%20N&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AN.%2BVarble%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="https://orcid.org/0000-0003-2273-7962" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for N. Varble</a></li></ul></div><div class="author-tooltip-3"><div class="author-tooltip-name">S.-I. Sugiyama </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>d</span>Department of Neuroanesthesia (S.-I.S.), Kohnan Hospital, Sendai, Japan</div><div class='author-affiliation'><span class='nlm-sup'>e</span>Department of Neurosurgery (S.-I.S., A.S.), Tohoku University Graduate School of Medicine, Sendai, Japan</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=S.-I.%2BSugiyama%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Sugiyama%20S&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AS.-I.%2BSugiyama%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="https://orcid.org/0000-0002-0406-8307" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for S.-I. Sugiyama</a></li></ul></div><div class="author-tooltip-4"><div class="author-tooltip-name">A. Shimizu </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>e</span>Department of Neurosurgery (S.-I.S., A.S.), Tohoku University Graduate School of Medicine, Sendai, Japan</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=A.%2BShimizu%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Shimizu%20A&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AA.%2BShimizu%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="https://orcid.org/0000-0001-9258-5250" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for A. Shimizu</a></li></ul></div><div class="author-tooltip-5"><div class="author-tooltip-name">L. Jing </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>f</span>Department of Interventional Neuroradiology (L.J., J.L., X.Y., H.M.), Beijing Neurosurgical Institute, Beijing Tiantan Hospital, Capital Medical University, Beijing, China</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=L.%2BJing%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Jing%20L&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AL.%2BJing%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="https://orcid.org/0000-0002-1655-7538" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for L. Jing</a></li></ul></div><div class="author-tooltip-6"><div class="author-tooltip-name">J. Liu </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>f</span>Department of Interventional Neuroradiology (L.J., J.L., X.Y., H.M.), Beijing Neurosurgical Institute, Beijing Tiantan Hospital, Capital Medical University, Beijing, China</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=J.%2BLiu%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Liu%20J&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AJ.%2BLiu%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="https://orcid.org/0000-0002-5454-2847" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for J. Liu</a></li></ul></div><div class="author-tooltip-7"><div class="author-tooltip-name">X. Yang </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>f</span>Department of Interventional Neuroradiology (L.J., J.L., X.Y., H.M.), Beijing Neurosurgical Institute, Beijing Tiantan Hospital, Capital Medical University, Beijing, China</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=X.%2BYang%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Yang%20X&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AX.%2BYang%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="https://orcid.org/0000-0001-7306-0125" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for X. Yang</a></li></ul></div><div class="author-tooltip-8"><div class="author-tooltip-name">A.H. Siddiqui </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>a</span>From the Canon Stroke and Vascular Research Center (H.R.-O., N.V., A.H.S., J.M.D., H.M.)</div><div class='author-affiliation'><span class='nlm-sup'>g</span>Departments of Neurosurgery (A.H.S., J.M.D.)</div><div class='author-affiliation'><span class='nlm-sup'>i</span>Radiology (A.H.S.), Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, New York</div><div class='author-affiliation'><span class='nlm-sup'>j</span>Jacobs Institute (A.H.S., J.M.D), Buffalo, New York</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=A.H.%2BSiddiqui%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Siddiqui%20A&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AA.H.%2BSiddiqui%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="https://orcid.org/0000-0002-9519-0059" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for A.H. Siddiqui</a></li></ul></div><div class="author-tooltip-9"><div class="author-tooltip-name">J.M. Davies </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>a</span>From the Canon Stroke and Vascular Research Center (H.R.-O., N.V., A.H.S., J.M.D., H.M.)</div><div class='author-affiliation'><span class='nlm-sup'>g</span>Departments of Neurosurgery (A.H.S., J.M.D.)</div><div class='author-affiliation'><span class='nlm-sup'>h</span>Bioinformatics (J.M.D.)</div><div class='author-affiliation'><span class='nlm-sup'>j</span>Jacobs Institute (A.H.S., J.M.D), Buffalo, New York</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=J.M.%2BDavies%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Davies%20J&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AJ.M.%2BDavies%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="https://orcid.org/0000-0002-5225-3072" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for J.M. Davies</a></li></ul></div><div class="author-tooltip-10"><div class="author-tooltip-name">H. Meng </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>a</span>From the Canon Stroke and Vascular Research Center (H.R.-O., N.V., A.H.S., J.M.D., H.M.)</div><div class='author-affiliation'><span class='nlm-sup'>b</span>Departments of Mechanical and Aerospace Engineering (H.R.-O., N.V., H.M.)</div><div class='author-affiliation'><span class='nlm-sup'>f</span>Department of Interventional Neuroradiology (L.J., J.L., X.Y., H.M.), Beijing Neurosurgical Institute, Beijing Tiantan Hospital, Capital Medical University, Beijing, China</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=H.%2BMeng%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Meng%20H&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AH.%2BMeng%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="https://orcid.org/0000-0003-3884-499X" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for H. Meng</a></li></ul></div></div></div>  </div>

  
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    <div class="highwire-article-citation highwire-citation-type-highwire-article node71288" data-node-nid="71288" id="node-71288--21777682323" data-pisa="ajnr;40/11/1939" data-pisa-master="ajnr;ajnr.A6259" data-apath="/ajnr/40/11/1939.atom"><div class="highwire-cite highwire-cite-highwire-article highwire-citation-highwire-article-info clearfix">
  
  
  
  
  
  
    	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-volume highwire-cite-metadata">vol. 40 </span><span  class="highwire-cite-metadata-issue highwire-cite-metadata">no. 11 </span><span  class="highwire-cite-metadata-page-string highwire-cite-metadata">1939-1946 </span></div>
  
  
  
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    <div class="field field-name-field-highwire-publication-history field-type-text field-label-inline clearfix"><div class="field-label">History&nbsp;</div><div class="field-items"><div class="field-item even"><ul class="publication-history"><li>Received  December 5, 2018</li><li>Accepted after revision  August 23, 2019</li><li class="published"><span class="published-label">Published online</span> November 13, 2019.</li></ul></div></div></div>  </div>

  
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    <div class="highwire-markup"><div xmlns="http://www.w3.org/1999/xhtml" class="content-block-markup" xmlns:xhtml="http://www.w3.org/1999/xhtml"><div xmlns:xhtml="http://www.w3.org/1999/xhtml" class="contributors"><ol class="contributor-list" id="contrib-group-1"><li class="contributor" id="contrib-1"><span class="name">H. Rajabzadeh-Oghaz</span><a id="xref-aff-1-1" class="xref-aff" href="#aff-1">a</a><span class="xref-sep">,</span><a id="xref-aff-2-1" class="xref-aff" href="#aff-2">b</a>, </li><li class="contributor" id="contrib-2"><span class="name">J. Wang</span><a id="xref-aff-3-1" class="xref-aff" href="#aff-3">c</a>, </li><li class="contributor" id="contrib-3"><span class="name">N. Varble</span><a id="xref-aff-1-2" class="xref-aff" href="#aff-1">a</a><span class="xref-sep">,</span><a id="xref-aff-2-2" class="xref-aff" href="#aff-2">b</a>, </li><li class="contributor" id="contrib-4"><span class="name">S.-I. Sugiyama</span><a id="xref-aff-4-1" class="xref-aff" href="#aff-4">d</a><span class="xref-sep">,</span><a id="xref-aff-5-1" class="xref-aff" href="#aff-5">e</a>, </li><li class="contributor" id="contrib-5"><span class="name">A. Shimizu</span><a id="xref-aff-5-2" class="xref-aff" href="#aff-5">e</a>, </li><li class="contributor" id="contrib-6"><span class="name">L. Jing</span><a id="xref-aff-6-1" class="xref-aff" href="#aff-6">f</a>, </li><li class="contributor" id="contrib-7"><span class="name">J. Liu</span><a id="xref-aff-6-2" class="xref-aff" href="#aff-6">f</a>, </li><li class="contributor" id="contrib-8"><span class="name">X. Yang</span><a id="xref-aff-6-3" class="xref-aff" href="#aff-6">f</a>, </li><li class="contributor" id="contrib-9"><span class="name">A.H. Siddiqui</span><a id="xref-aff-1-3" class="xref-aff" href="#aff-1">a</a><span class="xref-sep">,</span><a id="xref-aff-7-1" class="xref-aff" href="#aff-7">g</a><span class="xref-sep">,</span><a id="xref-aff-9-1" class="xref-aff" href="#aff-9">i</a><span class="xref-sep">,</span><a id="xref-aff-10-1" class="xref-aff" href="#aff-10">j</a>, </li><li class="contributor" id="contrib-10"><span class="name">J.M. Davies</span><a id="xref-aff-1-4" class="xref-aff" href="#aff-1">a</a><span class="xref-sep">,</span><a id="xref-aff-7-2" class="xref-aff" href="#aff-7">g</a><span class="xref-sep">,</span><a id="xref-aff-8-1" class="xref-aff" href="#aff-8">h</a><span class="xref-sep">,</span><a id="xref-aff-10-2" class="xref-aff" href="#aff-10">j</a> and </li><li class="last" id="contrib-11"><span class="name">H. Meng</span><a id="xref-aff-1-5" class="xref-aff" href="#aff-1">a</a><span class="xref-sep">,</span><a id="xref-aff-2-3" class="xref-aff" href="#aff-2">b</a><span class="xref-sep">,</span><a id="xref-aff-6-4" class="xref-aff" href="#aff-6">f</a></li></ol><ol class="affiliation-list"><li class="aff"><a id="aff-1" name="aff-1"></a><address><sup>a</sup>From the Canon Stroke and Vascular Research Center (H.R.-O., N.V., A.H.S., J.M.D., H.M.)</address></li><li class="aff"><a id="aff-2" name="aff-2"></a><address><sup>b</sup>Departments of Mechanical and Aerospace Engineering (H.R.-O., N.V., H.M.)</address></li><li class="aff"><a id="aff-3" name="aff-3"></a><address><sup>c</sup>Biostatistics (J.W.), University at Buffalo, Buffalo, New York</address></li><li class="aff"><a id="aff-4" name="aff-4"></a><address><sup>d</sup>Department of Neuroanesthesia (S.-I.S.), Kohnan Hospital, Sendai, Japan</address></li><li class="aff"><a id="aff-5" name="aff-5"></a><address><sup>e</sup>Department of Neurosurgery (S.-I.S., A.S.), Tohoku University Graduate School of Medicine, Sendai, Japan</address></li><li class="aff"><a id="aff-6" name="aff-6"></a><address><sup>f</sup>Department of Interventional Neuroradiology (L.J., J.L., X.Y., H.M.), Beijing Neurosurgical Institute, Beijing Tiantan Hospital, Capital Medical University, Beijing, China</address></li><li class="aff"><a id="aff-7" name="aff-7"></a><address><sup>g</sup>Departments of Neurosurgery (A.H.S., J.M.D.)</address></li><li class="aff"><a id="aff-8" name="aff-8"></a><address><sup>h</sup>Bioinformatics (J.M.D.)</address></li><li class="aff"><a id="aff-9" name="aff-9"></a><address><sup>i</sup>Radiology (A.H.S.), Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, New York</address></li><li class="aff"><a id="aff-10" name="aff-10"></a><address><sup>j</sup>Jacobs Institute (A.H.S., J.M.D), Buffalo, New York</address></li></ol><ol class="corresp-list"><li class="corresp" id="corresp-1">Please address correspondence to Hui Meng, PhD, <span class="addr-line">Canon Stroke and Vascular Research Center, Clinical Translational Research Center, 875 Ellicott St, Buffalo, NY 14203</span>; e-mail: <span class="em-link"><span class="em-addr">huimeng{at}buffalo.edu</span></span></li></ol></div></div><a href="http://ajnr-stage2.stage.highwire.org/content/40/11/1939.full" class="hw-link hw-link-article-full-text" data-icon-position="" data-hide-link-title="0">View Full Text</a></div>  </div>

  
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      <div class="highwire-cite-title">Novel Models for Identification of the Ruptured Aneurysm in Patients with Subarachnoid Hemorrhage with Multiple Aneurysms</div>  
    	<div class="highwire-cite-authors"><span  class="highwire-citation-authors"><span class="highwire-citation-author first" data-delta="0"><span class="nlm-given-names">H.</span> <span class="nlm-surname">Rajabzadeh-Oghaz</span></span>, <span class="highwire-citation-author" data-delta="1"><span class="nlm-given-names">J.</span> <span class="nlm-surname">Wang</span></span>, <span class="highwire-citation-author" data-delta="2"><span class="nlm-given-names">N.</span> <span class="nlm-surname">Varble</span></span>, <span class="highwire-citation-author" data-delta="3"><span class="nlm-given-names">S.-I.</span> <span class="nlm-surname">Sugiyama</span></span>, <span class="highwire-citation-author" data-delta="4"><span class="nlm-given-names">A.</span> <span class="nlm-surname">Shimizu</span></span>, <span class="highwire-citation-author" data-delta="5"><span class="nlm-given-names">L.</span> <span class="nlm-surname">Jing</span></span>, <span class="highwire-citation-author" data-delta="6"><span class="nlm-given-names">J.</span> <span class="nlm-surname">Liu</span></span>, <span class="highwire-citation-author" data-delta="7"><span class="nlm-given-names">X.</span> <span class="nlm-surname">Yang</span></span>, <span class="highwire-citation-author" data-delta="8"><span class="nlm-given-names">A.H.</span> <span class="nlm-surname">Siddiqui</span></span>, <span class="highwire-citation-author" data-delta="9"><span class="nlm-given-names">J.M.</span> <span class="nlm-surname">Davies</span></span>, <span class="highwire-citation-author" data-delta="10"><span class="nlm-given-names">H.</span> <span class="nlm-surname">Meng</span></span></span></div>
  
    	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-oa-ind highwire-cite-metadata"><i class="highwire-oa-indicator"></i> </span><span  class="highwire-cite-metadata-journal highwire-cite-metadata">American Journal of Neuroradiology </span><span  class="highwire-cite-metadata-date highwire-cite-metadata">Nov 2019, </span><span  class="highwire-cite-metadata-volume highwire-cite-metadata">40 </span><span  class="highwire-cite-metadata-issue highwire-cite-metadata">(11) </span><span  class="highwire-cite-metadata-pages highwire-cite-metadata">1939-1946; </span><span  class="highwire-cite-metadata-doi highwire-cite-metadata"><span class="label">DOI:</span> 10.3174/ajnr.A6259 </span></div>
  
  
  
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      <div class="highwire-cite-title">Novel Models for Identification of the Ruptured Aneurysm in Patients with Subarachnoid Hemorrhage with Multiple Aneurysms</div>  
    	<div class="highwire-cite-authors"><span  class="highwire-citation-authors"><span class="highwire-citation-author first" data-delta="0"><span class="nlm-given-names">H.</span> <span class="nlm-surname">Rajabzadeh-Oghaz</span></span>, <span class="highwire-citation-author" data-delta="1"><span class="nlm-given-names">J.</span> <span class="nlm-surname">Wang</span></span>, <span class="highwire-citation-author" data-delta="2"><span class="nlm-given-names">N.</span> <span class="nlm-surname">Varble</span></span>, <span class="highwire-citation-author" data-delta="3"><span class="nlm-given-names">S.-I.</span> <span class="nlm-surname">Sugiyama</span></span>, <span class="highwire-citation-author" data-delta="4"><span class="nlm-given-names">A.</span> <span class="nlm-surname">Shimizu</span></span>, <span class="highwire-citation-author" data-delta="5"><span class="nlm-given-names">L.</span> <span class="nlm-surname">Jing</span></span>, <span class="highwire-citation-author" data-delta="6"><span class="nlm-given-names">J.</span> <span class="nlm-surname">Liu</span></span>, <span class="highwire-citation-author" data-delta="7"><span class="nlm-given-names">X.</span> <span class="nlm-surname">Yang</span></span>, <span class="highwire-citation-author" data-delta="8"><span class="nlm-given-names">A.H.</span> <span class="nlm-surname">Siddiqui</span></span>, <span class="highwire-citation-author" data-delta="9"><span class="nlm-given-names">J.M.</span> <span class="nlm-surname">Davies</span></span>, <span class="highwire-citation-author" data-delta="10"><span class="nlm-given-names">H.</span> <span class="nlm-surname">Meng</span></span></span></div>
  
    	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-oa-ind highwire-cite-metadata"><i class="highwire-oa-indicator"></i> </span><span  class="highwire-cite-metadata-journal highwire-cite-metadata">American Journal of Neuroradiology </span><span  class="highwire-cite-metadata-date highwire-cite-metadata">Nov 2019, </span><span  class="highwire-cite-metadata-volume highwire-cite-metadata">40 </span><span  class="highwire-cite-metadata-issue highwire-cite-metadata">(11) </span><span  class="highwire-cite-metadata-pages highwire-cite-metadata">1939-1946; </span><span  class="highwire-cite-metadata-doi highwire-cite-metadata"><span class="label">DOI:</span> 10.3174/ajnr.A6259 </span></div>
  
  
  
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