Intra-Aneurysmal High-Resolution 4D MR Flow Imaging for Hemodynamic Imaging Markers in Intracranial Aneurysm Instability.

Autor: van Tuijl RJ; From the Department of Radiology (R.J.v.T., K.M.T., B.K.V., I.C.v.d.S.), University Medical Center Utrecht, Utrecht, the Netherlands.; Translational Neuroimaging Group, Center for Image Sciences (R.J.v.T., J.J.M.Z.), University Medical Center Utrecht, Utrecht, the Netherlands., den Hertog CS; Department of Neurology and Neurosurgery, UMC Utrecht Brain Center (C.S.d.H., Y.M.R.), University Medical Center Utrecht Brain Center, University Medical Center Utrecht, Utrecht, the Netherlands coendenhertog@hotmail.nl., Timmins KM; From the Department of Radiology (R.J.v.T., K.M.T., B.K.V., I.C.v.d.S.), University Medical Center Utrecht, Utrecht, the Netherlands., Velthuis BK; From the Department of Radiology (R.J.v.T., K.M.T., B.K.V., I.C.v.d.S.), University Medical Center Utrecht, Utrecht, the Netherlands., van Ooij P; Department of Radiology & Nuclear Medicine (P.v.O.), Amsterdam University Medical Center location AMC, Amsterdam, the Netherlands.; Department of Pediatric Cardiology (P.v.O.), University Medical Center Utrecht, Utrecht, the Netherlands., Zwanenburg JJM; Translational Neuroimaging Group, Center for Image Sciences (R.J.v.T., J.J.M.Z.), University Medical Center Utrecht, Utrecht, the Netherlands., Ruigrok YM; Department of Neurology and Neurosurgery, UMC Utrecht Brain Center (C.S.d.H., Y.M.R.), University Medical Center Utrecht Brain Center, University Medical Center Utrecht, Utrecht, the Netherlands., van der Schaaf IC; From the Department of Radiology (R.J.v.T., K.M.T., B.K.V., I.C.v.d.S.), University Medical Center Utrecht, Utrecht, the Netherlands.
Jazyk: angličtina
Zdroj: AJNR. American journal of neuroradiology [AJNR Am J Neuroradiol] 2024 Nov 07; Vol. 45 (11), pp. 1678-1684. Date of Electronic Publication: 2024 Nov 07.
DOI: 10.3174/ajnr.A8380
Abstrakt: Background and Purpose: Prediction of aneurysm instability is crucial to guide treatment decisions and to select appropriate patients with unruptured intracranial aneurysms (IAs) for preventive treatment. High-resolution 4D MR flow imaging and 3D quantification of aneurysm morphology could offer insights and new imaging markers for aneurysm instability. In this cross-sectional study, we aim to identify 4D MR flow imaging markers for aneurysm instability by relating hemodynamics in the aneurysm sac to 3D morphologic proxy parameters for aneurysm instability.
Materials and Methods: In 35 patients with 37 unruptured IAs, a 3T MRA and a 7T 4D MRI flow scan were performed. Five hemodynamic parameters-peak-systolic wall shear stress (WSS MAX ) and time-averaged wall shear stress (WSS MEAN ), oscillatory shear index (OSI), mean velocity, and velocity pulsatility index-were correlated to 6 3D morphology proxy parameters of aneurysm instability-major axis length, volume, surface area (all 3 size parameters), flatness, shape index, and curvedness-by Pearson correlation with 95% CI. Scatterplots of hemodynamic parameters that correlated with IA size (major axis length) were created.
Results: WSS MAX and WSS MEAN correlated negatively with all 3 size parameters (strongest for WSS MEAN with volume ( r = -0.70, 95% CI -0.83 to -0.49) and OSI positively (strongest with major axis length [ r = 0.87, 95% CI 0.76-0.93]). WSS MAX and WSS MEAN correlated positively with shape index ( r = 0.61, 95% CI 0.36-0.78 and r = 0.49, 95% CI 0.20-0.70, respectively) and OSI negatively ( r = -0.82, 95% CI -0.9 to -0.68). WSS MEAN and mean velocity correlated negatively with flatness ( r = -0.35, 95% CI -0.61 to -0.029 and r = -0.33, 95% CI -0.59 to 0.007, respectively) and OSI positively ( r = 0.54, 95% CI 0.26-0.74). Velocity pulsatility index did not show any statistically relevant correlation.
Conclusions: Out of the 5 included hemodynamic parameters, WSS MAX , WSS MEAN , and OSI showed the strongest correlation with morphologic 3D proxy parameters of aneurysm instability. Future studies should assess these promising new imaging marker parameters for predicting aneurysm instability in longitudinal cohorts of patients with IA.
(© 2024 by American Journal of Neuroradiology.)
Databáze: MEDLINE
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