Moments of Intra-Dome Velocity Distribution as Robust Predictors of Rupture Status in Cerebral Aneurysms

Wall shear stress (WSS), the spatial gradient of flow velocity at luminal surface, has been employed for aneurysmal hemodynamic analysis, but it is sensitive to surface irregularities and noise. We devised a volumetric approach to evaluate discriminant power of intra-dome flow velocity distribution...

Full description

Saved in:
Bibliographic Details
Published in:World neurosurgery 2022-02, Vol.158, p.e334-e343
Main Authors: Lauric, Alexandra, Hippelheuser, James E., Malek, Adel M.
Format: Article
Language:English
Subjects:
Aneurysm, Ruptured - diagnostic imaging
Aneurysm, Ruptured - pathology
Computational fluid dynamics
Hemodynamics
Humans
Hydrodynamics
Intracranial Aneurysm - diagnostic imaging
Intracranial Aneurysm - pathology
Intracranial aneurysms
Rupture status
Velocity
Citations: Items that this one cites
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Wall shear stress (WSS), the spatial gradient of flow velocity at luminal surface, has been employed for aneurysmal hemodynamic analysis, but it is sensitive to surface irregularities and noise. We devised a volumetric approach to evaluate discriminant power of intra-dome flow velocity distribution and modal analysis in rupture status determination compared with previously described WSS analysis. Catheter three-dimensional rotational angiographic datasets matched for volume were segmented in 20 sidewall aneurysms (10 ruptured), computational fluid dynamics simulations were performed, and velocity distributions were extracted from mesh-independent isometric sampling followed by moment analysis (mean, variance, skewness, and kurtosis). Univariate and multivariate analysis was used to evaluate discriminant performance of velocity moments. Sensitivity of velocity moments and WSS was evaluated to bleb presence and surface irregularity using digital bleb removal and surface noise addition. Velocity moments of ruptured aneurysms showed higher skewness (2.45 ± 0.57 vs. 1.36 ± 0.82, P = 0.003) and kurtosis (11.83 ± 4.77 vs. 6.05 ± 4.65, P = 0.01) with lower mean (0.019 ± 0.01 vs. 0.038 ± 0.02, P = 0.03) compared with unruptured lesions; in multivariate modeling, skewness alone emerged as best predictor (area under the curve = 0.88). Bleb removal increased low WSS by 548%, and surface noise decreased it by 85.8% while having a smaller (
ISSN:1878-8750
1878-8769
DOI:10.1016/j.wneu.2021.10.178