Wall enhancement (AWE) of intracranial aneurysms (IAs) on high-resolution black blood MRI has been described in ruptured aneurysms. This study investigated 103 unruptured saccular IAs and aims to assess the association between AWE and traditional risk factors and estimated one-year and five-year rupture risk estimated from previous large trails. We found aneurysms with AWE had more than 3 times higher estimated rupture risk (one-year and 5-year, 2.2% and 6.7%) than aneurysms without AWE (0.6% and 2.0%), and AWE was associated with traditional risk factors (size, location, symptoms). Identifying AWE may improve the risk assessment of IAs.
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