Associations between haemodynamics and wall enhancement of intracranial aneurysm

Background and purposePrevious studies have reported about inflammation processes (IPs) that play important roles in aneurysm formation and rupture, which could be driven by blood flow. IPs can be identified using aneurysmal wall enhancement (AWE) on high-resolution black-blood MRI (BB-MRI) and bloo...

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Bibliographic Details
Published in:Stroke and vascular neurology 2021-09, Vol.6 (3), p.467-475
Main Authors: Zhang, Miaoqi, Peng, Fei, Tong, Xin, Feng, Xin, Li, Yunduo, Chen, Huijun, Niu, Hao, Zhang, Baorui, Song, Guangrong, Li, Youxiang, Liu, Peng, Liu, Aihua, Li, Rui
Format: Article
Language:English
Subjects:
aneurysm
Aneurysms
Hemodynamics
Humans
inflammation
Intracranial Aneurysm - diagnostic imaging
Investigations
Magnetic Resonance Imaging - methods
Medical imaging
MRI
Original Research
Retrospective Studies
Shear stress
Stress, Mechanical
Velocity
vessel wall
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Summary:Background and purposePrevious studies have reported about inflammation processes (IPs) that play important roles in aneurysm formation and rupture, which could be driven by blood flow. IPs can be identified using aneurysmal wall enhancement (AWE) on high-resolution black-blood MRI (BB-MRI) and blood flow haemodynamics can be demonstrated by four-dimensional-flow MRI (4D-flow MRI). Thus, this study investigated the associations between AWE and haemodynamics in unruptured intracranial aneurysms (IA) by combining 4D-flow MRI and high-resolution BB-MRI.Materials and methodsBetween April 2014 and October 2017, 48 patients with 49 unruptured IA who underwent both 4D-flow MRI and high-resolution BB-MRI were retrospectively included in this study. The haemodynamic parameters demonstrated using 4D-flow MRI were compared between different AWE patterns using the Kruskal-Wallis test and ordinal regression.ResultsThe results of Kruskal-Wallis test showed that the average wall shear stress in the IA (WSSavg-IA), maximum through-plane velocity in the adjacent parent artery, inflow jet patterns and the average vorticity in IA (vorticityavg-IA) were significantly associated with the AWE patterns. Ordinal regression analysis identified WSSavg-IA (p=0.002) and vorticityavg-IA (p=0.033) as independent predictors of AWE patterns.ConclusionA low WSS and low average vorticity were independently associated with a high AWE grade for IAs larger than 4 mm. Therefore, WSS and average vorticity could predict AWE and circumferential AWE.
ISSN:2059-8688
2059-8696
DOI:10.1136/svn-2020-000636