Wall Enhancement, Hemodynamics, and Morphology in Unruptured Intracranial Aneurysms with High Rupture Risk

The purpose of this study is to investigate the relationship between morphology, hemodynamics, and aneurysm wall enhancement (AWE) on vessel wall MRI and their potential role in rupture of intracranial aneurysms. Fifty-seven patients (22 males and 35 females; mean age of 58.4) harboring 65 unrupture...

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Bibliographic Details
Published in:Translational stroke research 2020-10, Vol.11 (5), p.882-889
Main Authors: Lv, Nan, Karmonik, Christof, Chen, Shiyue, Wang, Xinrui, Fang, Yibin, Huang, Qinghai, Liu, Jianmin
Format: Article
Language:English
Subjects:
Aneurysms
Biomedical and Life Sciences
Biomedicine
Cardiology
Contrast agents
Fluid dynamics
Hemodynamics
Hypertension
Magnetic resonance imaging
Medical imaging
Morphology
Neurology
Neurosciences
Neurosurgery
Original
Original Article
Pathogenesis
Patients
Simulation
Vascular Surgery
Veins & arteries
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Summary:The purpose of this study is to investigate the relationship between morphology, hemodynamics, and aneurysm wall enhancement (AWE) on vessel wall MRI and their potential role in rupture of intracranial aneurysms. Fifty-seven patients (22 males and 35 females; mean age of 58.4) harboring 65 unruptured intracranial aneurysms were retrospectively recruited. Vessel wall MRI images were reviewed and differentiated as no (NAWE), partial (PAWE), and circumferential (CAWE) wall enhancement. Computational geometry and computational fluid dynamics were used to calculate morphological and hemodynamic parameters. The PHASES score was calculated for each case to estimate its rupture risk. Univariate and multivariate logistic regression analysis was performed to investigate the relationship between morphological-hemodynamic pattern and AWE as well as their association with rupture risk. AWE was present in 26 (40.0%) lesions, including 14 (21.5%) PAWE and 12 (18.5%) CAWE. Aneurysm size (odds ratio = 7.46, 95% confidence interval = 1.56–35.77, p  = 0.012), size ratio (odds ratio = 12.90, 95% confidence interval = 2.28–72.97, p  = 0.004), and normalized wall shear stress (odds ratio = 0.11, 95% confidence interval = 0.02–0.69, p  = 0.018) were independently associated with the presence of AWE. With increasing PHASES score, size-related parameters and the frequency of irregular shape increased significantly, and a hemodynamic pattern of lower and oscillating wall shear stress was observed. Simultaneously, the proportion of NAWE aneurysms decreased, and PAWE and CAWE aneurysms increased significantly ( p  
ISSN:1868-4483
1868-601X
DOI:10.1007/s12975-020-00782-4