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Ren X, Li H, Xu K, Li Z, Gao B, Lu W, Yang G, Wang Y, Yin Y, Chen T. Hemodynamic study on the therapeutic effects of varying diameter embolic coils in the treatment of intracranial aneurysms. INTERNATIONAL JOURNAL FOR NUMERICAL METHODS IN BIOMEDICAL ENGINEERING 2024; 40:e3807. [PMID: 38281812 DOI: 10.1002/cnm.3807] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Revised: 12/13/2023] [Accepted: 01/14/2024] [Indexed: 01/30/2024]
Abstract
Endovascular coiling is the predominant method for treating cerebral aneurysms. Extensive reports on selecting coil length, hardness, and material are available. However, the impact of coil diameter on postoperative outcomes remains unclear. This study enrolled six personalized geometric models of intracranial aneurysms: three bifurcation aneurysms and three sidewall aneurysms. Four coil models were constructed by changing the coil diameter. Coil embolization was simulated using the finite element method. Computational fluid dynamics was used to characterize hemodynamics in the aneurysms after embolization. Evaluation parameters included velocity reduction, wall shear stress (WSS), low WSS (LWSS), oscillatory shear index (OSI), relative residence time (RRT), and residual flow volume in the aneurysms. At the peak time (t = 0.17 s), the proportion of LWSS area in bifurcation aneurysms increase with the rise in coil diameter: 0.8D, 71.28 ± 12.62% versus 1D, 74.97 ± 19.17% versus 1.2D, 78.88 ± 18.56% versus 1.4D, 84.00 ± 11.53% (mean ± SD). The proportion of high OSI area decreases as the coil diameter increases: 0.8D, 4.41% ± 2.82% versus 1.0D, 3.78 ± 3.33% versus 1.2D, 2.28% ± 1.77% versus 1.4D, 1.58% ± 1.11% (mean ± SD). The proportion of high RRT area increases as the coil diameter rises: 0.8D, 3.40% ± 1.68% versus 1.0D, 7.67 ± 4.12% versus 1.2D, 9.84% ± 9.50% versus 1.4D, 22.29% ± 14.28% (mean ± SD). Side wall aneurysms do not exhibit the aforementioned trend. Bifurcation aneurysms plugged with a coil of 1.4 times the diameter have the largest RFVs (<10 mm/s) within the group. Aforementioned patterns are not found in sidewall aneurysms. In the treatment of aneurysms with coiling, varying coil diameters can result in different hemodynamic environments within the aneurysm. Larger coil diameters have improved hemodynamic performance for bifurcation aneurysms. However, coil diameter and embolization effectiveness have no significant relationship for sidewall aneurysms.
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Affiliation(s)
- Xiaoyu Ren
- Faculty of Environment and Life, Beijing University of Technology, Beijing, China
| | - Haoran Li
- Faculty of Environment and Life, Beijing University of Technology, Beijing, China
| | - Kaihang Xu
- Faculty of Environment and Life, Beijing University of Technology, Beijing, China
| | - Zhongkai Li
- Faculty of Environment and Life, Beijing University of Technology, Beijing, China
| | - Bin Gao
- Faculty of Environment and Life, Beijing University of Technology, Beijing, China
| | - Wangsheng Lu
- Union Strong (Beijing) Technology Co. Ltd., Beijing, China
| | - Guangming Yang
- Union Strong (Beijing) Technology Co. Ltd., Beijing, China
| | - Yunjie Wang
- Union Strong (Beijing) Technology Co. Ltd., Beijing, China
| | - Yin Yin
- Union Strong (Beijing) Technology Co. Ltd., Beijing, China
| | - Tao Chen
- Fuwai Central China Cardiovascular Hospital, Zhengzhou, China
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Inflow Hemodynamics of Intracranial Aneurysms: A Comparison of Computational Fluid Dynamics and 4D Flow Magnetic Resonance Imaging. J Stroke Cerebrovasc Dis 2021; 30:105685. [PMID: 33662703 DOI: 10.1016/j.jstrokecerebrovasdis.2021.105685] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2021] [Accepted: 02/13/2021] [Indexed: 11/22/2022] Open
Abstract
PURPOSE Although the inflow hemodynamics of cerebral aneurysms are key factors in their rupture and recurrence after endovascular treatments, the most available method for inflow hemodynamics evaluation remains unestablished. We compared the efficacy of inflow hemodynamics evaluation using computational fluid dynamics (CFD) analysis and that using four-dimensional (4D) flow magnetic resonance imaging (MRI). METHODS In 23 unruptured cerebral aneurysms, the inflow hemodynamics was evaluated using both CFD and 4D flow MRI. The evaluated parameters included visually classified inflow jet patterns, the inflow rate ratio (the ratio of the inflow rate at the aneurysmal orifice to the flow rate in the proximal parent artery), and the velocity ratio (the ratio of the inflow velocity to the velocity in the proximal parent artery). The Shapiro-Wilk test was used to assess the normality of variable data, and logarithmic transformation was performed for variables with non-normal distributions. Data analysis was performed using Pearson correlation analyses and the chi-square test. RESULTS There was a significant correlation between inflow jet patterns evaluated by CFD and 4D flow MRI (p = 0.008). Moreover, there was a strong correlation between the inflow rate ratios evaluated by CFD and 4D flow MRI (r = 0.801; p <0.001). Furthermore, there was a moderate correlation between the velocity ratios measured by CFD and 4D flow MRI (r = 0.559; p = 0.008). CONCLUSION Inflow hemodynamics evaluated by CFD analysis and 4D flow MRI showed good correlations in inflow jet pattern, inflow rate ratio, and velocity ratio.
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Le TB. Dynamic modes of inflow jet in brain aneurysms. J Biomech 2021; 116:110238. [PMID: 33485144 DOI: 10.1016/j.jbiomech.2021.110238] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Accepted: 01/04/2021] [Indexed: 01/27/2023]
Abstract
The transition of the inflow jet to turbulence is crucial in understanding the pathology of brain aneurysms. Previous works Le et al. (2010, 2013) have shown evidence for a highly dynamic inflow jet in the ostium of brain aneurysms. While it is highly desired to investigate this inflow jet dynamics in clinical practice, the constraints on spatial and temporal resolutions of in vivo data do not allow a detailed analysis of this transition. In this work, Dynamic Mode Decomposition (DMD) is used to identify the most energetic modes of the inflow jet in patient-specific models of internal carotid aneurysms via the utilization of high-resolution simulation data. It is hypothesized that dynamic modes are not solely controlled by the blood flow waveform at the parent artery. They are also dependent on jet-wall interaction phenomena. DMD analysis shows that the spatial extent of low- frequency modes corresponds well to the most energetic areas of the inflow jet. The high-frequency modes are short-lived and correspond to the flow separation at the proximal neck and the jet's impingement onto the aneurysmal wall. Low-frequency modes can be reconstructed at relatively low spatial and temporal resolutions comparable to ones of in vivo data. The current results suggest that DMD can be practically useful in analyzing blood flow patterns of brain aneurysms with in vivo data.
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Affiliation(s)
- Trung Bao Le
- Department of Civil and Environmental Engineering, North Dakota State University, CIE 201, 1410 North 14th Avenue, Fargo, ND 58105-5285, United States; NDSU-UND Biomedical Engineering Program, United States; Center for Cellular Biointerfaces in Science and Engineering, United States.
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Youn SW, Lee J. From 2D to 4D Phase-Contrast MRI in the Neurovascular System: Will It Be a Quantum Jump or a Fancy Decoration? J Magn Reson Imaging 2020; 55:347-372. [PMID: 33236488 DOI: 10.1002/jmri.27430] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Revised: 10/20/2020] [Accepted: 10/21/2020] [Indexed: 12/16/2022] Open
Abstract
Considering the crosstalk between the flow and vessel wall, hemodynamic assessment of the neurovascular system may offer a well-integrated solution for both diagnosis and management by adding prognostic significance to the standard CT/MR angiography. 4D flow MRI or time-resolved 3D velocity-encoded phase-contrast MRI has long been promising for the hemodynamic evaluation of the great vessels, but challenged in clinical studies for assessing intracranial vessels with small diameter due to long scan times and low spatiotemporal resolution. Current accelerated MRI techniques, including parallel imaging with compressed sensing and radial k-space undersampling acquisitions, have decreased scan times dramatically while preserving spatial resolution. 4D flow MRI visualized and measured 3D complex flow of neurovascular diseases such as aneurysm, arteriovenous shunts, and atherosclerotic stenosis using parameters including flow volume, velocity vector, pressure gradients, and wall shear stress. In addition to the noninvasiveness of the phase contrast technique and retrospective flow measurement through the wanted windows of the analysis plane, 4D flow MRI has shown several advantages over Doppler ultrasound or computational fluid dynamics. The evaluation of the flow status and vessel wall can be performed simultaneously in the same imaging modality. This article is an overview of the recent advances in neurovascular 4D flow MRI techniques and their potential clinical applications in neurovascular disease. LEVEL OF EVIDENCE: 5 TECHNICAL EFFICACY STAGE: 3.
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Affiliation(s)
- Sung Won Youn
- Department of Radiology, Catholic University of Daegu School of Medicine, Daegu, Korea
| | - Jongmin Lee
- Department of Radiology and Biomedical Engineering, Kyungpook National University School of Medicine, Daegu, Korea
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Abdalkader M, Raymond J, Mian A, Naragum V, Cronk K, Roy D, Weill A, Nguyen TN. Early major recurrence of cerebral aneurysms after satisfactory initial coiling. Interv Neuroradiol 2020; 27:172-180. [PMID: 33076750 DOI: 10.1177/1591019920968370] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
Abstract
BACKGROUND AND PURPOSE Early major recurrence (EMR) of cerebral aneurysms treated by coiling has not been investigated. The purpose of this study is to characterize the frequency and risk factors of this phenomenon. MATERIALS AND METHODS A retrospective review was performed of consecutive patients who presented with ruptured and unruptured cerebral aneurysms and underwent coiling from July 2009 to June 2019 at a university hospital. We defined EMR as recurrence of the aneurysm greater than its initial size within the first 6 months of an initial satisfactory coil embolization. Patient demographics, clinical information, aneurysm characteristics, angiographic and technical details were reviewed. RESULTS From July 2009 to June 2019, 338 aneurysms (190 unruptured aneurysms and 148 ruptured cerebral aneurysms) underwent coiling and satisfied our study criteria. Among these patients, 23 patients (19 ruptured and 4 unruptured aneurysms) were found to have recurrent aneurysm. Of those, 4 were found to have early major aneurysm regrowth occurring within 6 months after coiling (1.2%). The detection of the EMR was as early as 4 weeks and as late as 20 weeks after the initial coil embolization. The average detection time was 10 ± 7.2 weeks (mean ± SD, range:4-20 weeks). In each case, the recurrent aneurysm cavity was more than twice the initial size of presentation. All aneurysms with major recurrence were ruptured with low aspect ratios (dome height to neck ratio) and involved a communicating segment. All patients underwent successful retreatment of the recurrent aneurysm with good outcome. CONCLUSIONS Early major recurrence of treated aneurysms is a rare but important complication that harbors an impending risk of re-rupture. Early control angiography after endovascular coiling may be warranted for small ruptured aneurysms, even in cases in which the initial result seems technically satisfactory.
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Affiliation(s)
| | - Jean Raymond
- Department of Radiology, Centre Hospitalier de l'Université de Montréal, University of Montreal, Montreal, Quebec, Canada
| | - Asim Mian
- Department of Radiology, Boston Medical Center, Boston, MA, USA
| | - Varun Naragum
- Department of Radiology, UMass Memorial Medical Center, Worcester, MA, USA
| | - Katharine Cronk
- Department of Neurosurgery, Southern New Hampshire Health, Nashua, NH, USA
| | - Daniel Roy
- Department of Radiology, Centre Hospitalier de l'Université de Montréal, University of Montreal, Montreal, Quebec, Canada
| | - Alain Weill
- Department of Radiology, Centre Hospitalier de l'Université de Montréal, University of Montreal, Montreal, Quebec, Canada
| | - Thanh N Nguyen
- Department of Radiology, Boston Medical Center, Boston, MA, USA.,Department of Neurology, Boston Medical Center, Boston, MA, USA.,Department of Neurosurgery, Boston Medical Center, Boston, MA, USA
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Howard BM, Hu R, Barrow JW, Barrow DL. Comprehensive review of imaging of intracranial aneurysms and angiographically negative subarachnoid hemorrhage. Neurosurg Focus 2020; 47:E20. [PMID: 31786554 DOI: 10.3171/2019.9.focus19653] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2019] [Accepted: 09/20/2019] [Indexed: 11/06/2022]
Abstract
Intracranial aneurysms confer the risk of subarachnoid hemorrhage (SAH), a potentially devastating condition, though most aneurysms will remain asymptomatic for the lifetime of the patient. Imaging is critical to all stages of patient care for those who harbor an unruptured intracranial aneurysm (UIA), including to establish the diagnosis, to determine therapeutic options, to undertake surveillance in patients who elect not to undergo treatment or whose aneurysm(s) portends such a low risk that treatment is not indicated, and to perform follow-up after treatment. Neuroimaging is equally as important in patients who suffer an SAH. DSA remains the reference standard for imaging of intracranial aneurysms due to its high spatial and temporal resolution. As noninvasive imaging technology, such as CTA and MRA, improves, the diagnostic accuracy of such tests continues to increasingly approximate that of DSA. In cases of angiographically negative SAH, imaging protocols are necessary not only for diagnosis but also to search for an initially occult vascular lesion, such as a thrombosed, ruptured aneurysm that might be detected in a delayed fashion. Given the crucial role of neuroimaging in all aspects of care for patients with UIAs and SAH, it is incumbent on those who care for these patients, including cerebrovascular neurosurgeons, interventional neurologists and neuroradiologists, and diagnostic radiologists and neurointensivists, to understand the role of imaging in this disease and how individual members of the multispecialty team use imaging to ensure best practices to deliver cutting-edge care to these often complex cases. This review expounds on the role of imaging in the management of UIAs and ruptured intracranial aneurysms and in the workup of angiographically negative subarachnoid hemorrhage.
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Affiliation(s)
- Brian M Howard
- 1Department of Neurosurgery, and.,2Department of Radiology and Imaging Sciences, Division of Interventional Neuroradiology, Emory University School of Medicine, Atlanta; and
| | - Ranliang Hu
- 2Department of Radiology and Imaging Sciences, Division of Interventional Neuroradiology, Emory University School of Medicine, Atlanta; and
| | - Jack W Barrow
- 3Mercer University School of Medicine, Savannah, Georgia
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Su T, Reymond P, Brina O, Bouillot P, Machi P, Delattre BMA, Jin L, Lövblad KO, Vargas MI. Large Neck and Strong Ostium Inflow as the Potential Causes for Delayed Occlusion of Unruptured Sidewall Intracranial Aneurysms Treated by Flow Diverter. AJNR Am J Neuroradiol 2020; 41:488-494. [PMID: 32054620 DOI: 10.3174/ajnr.a6413] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2019] [Accepted: 12/23/2019] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE Flow diverter-induced hemodynamic change plays an important role in the mechanism of intracranial aneurysm occlusion. Our aim was to explore the relationship between aneurysm features and flow-diverter treatment of unruptured sidewall intracranial aneurysms. MATERIALS AND METHODS MR imaging, 4D phase-contrast, was prospectively performed before flow diverter implantation in each patient with unruptured intracranial aneurysm. Two postprocedure follow-ups were scheduled at 6 and 12 months. Responses were grouped according to whether the aneurysms were occluded or remnant. Preprocedural aneurysm geometries and ostium hemodynamics in 38 patients were compared between the 2 groups at 6 and 12 months. Receiver operating characteristic curve analyses were performed for significant geometric and hemodynamic continuous parameters. RESULTS After the 6-month assessment, 21 of 41 intracranial aneurysms were occluded, and 9 additional aneurysms were occluded at 12 months. Geometrically, the ostium maximum diameter was significantly larger in the remnant group at 6 and 12 months (both P < .001). Hemodynamically, the proximal inflow zone was more frequently observed in the remnant group at 6 months. Several preprocedural ostium hemodynamic parameters were significantly higher in the remnant group. As a prediction for occlusion, the areas under the curve of the ostium maximum diameter (for 6 and 12 months), systolic inflow rate ratio (for 6 months), and systolic inflow area (for 12 months) reached 0.843, 0.883, 0.855, and 0.860, respectively. CONCLUSIONS Intracranial aneurysms with a large ostium and strong ostium inflow may need a longer time for occlusion. Preprocedural 4D flow MR imaging can well illustrate ostium hemodynamics and characterize aneurysm treatment responses.
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Affiliation(s)
- T Su
- From the Department of Interventional Radiology (T.S., L.J.), Beijing Friendship Hospital, Capital Medical University, Beijing, People's Republic of China
| | - P Reymond
- Division of Neuroradiology and Neuro-Interventional Radiology (P.R., O.B., P.M., K.O.L., M.I.V.)
| | - O Brina
- Division of Neuroradiology and Neuro-Interventional Radiology (P.R., O.B., P.M., K.O.L., M.I.V.)
| | - P Bouillot
- and Division of Radiology (B.M.A.D.), University Hospitals of Geneva, Geneva, Switzerland
| | - P Machi
- Division of Neuroradiology and Neuro-Interventional Radiology (P.R., O.B., P.M., K.O.L., M.I.V.)
| | - B M A Delattre
- Department of Quantum Matter Physics (P.B.), University of Geneva, Geneva, Switzerland
| | - L Jin
- From the Department of Interventional Radiology (T.S., L.J.), Beijing Friendship Hospital, Capital Medical University, Beijing, People's Republic of China
| | - K O Lövblad
- Division of Neuroradiology and Neuro-Interventional Radiology (P.R., O.B., P.M., K.O.L., M.I.V.)
| | - M I Vargas
- Division of Neuroradiology and Neuro-Interventional Radiology (P.R., O.B., P.M., K.O.L., M.I.V.)
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8
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Wen B, Tian S, Cheng J, Li Y, Zhang H, Xue K, Zhang Z, Fan Y, Wu B. Test–retest multisite reproducibility of neurovascular 4D flow MRI. J Magn Reson Imaging 2018; 49:1543-1552. [PMID: 30443945 DOI: 10.1002/jmri.26564] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2018] [Revised: 10/15/2018] [Accepted: 10/16/2018] [Indexed: 11/08/2022] Open
Affiliation(s)
- Baohong Wen
- Department of MRI First Affiliated Hospital of Zhengzhou University Zhengzhou Henan P.R. China
| | - Shuping Tian
- Department of Radiology Navy General Hospital Beijing P.R. China
| | - Jingliang Cheng
- Department of MRI First Affiliated Hospital of Zhengzhou University Zhengzhou Henan P.R. China
| | - Yinhua Li
- Department of MRI First Affiliated Hospital of Zhengzhou University Zhengzhou Henan P.R. China
| | - Huixia Zhang
- Department of MRI First Affiliated Hospital of Zhengzhou University Zhengzhou Henan P.R. China
| | - Kangkang Xue
- Department of MRI First Affiliated Hospital of Zhengzhou University Zhengzhou Henan P.R. China
| | - Zanxia Zhang
- Department of MRI First Affiliated Hospital of Zhengzhou University Zhengzhou Henan P.R. China
| | - Yang Fan
- GE Healthcare China Beijing P.R. China
| | - Bing Wu
- GE Healthcare China Beijing P.R. China
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Yoon NK, McNally S, Taussky P, Park MS. Imaging of cerebral aneurysms: a clinical perspective. ACTA ACUST UNITED AC 2016. [DOI: 10.1186/s40809-016-0016-3] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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10
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Futami K, Kitabayashi T, Sano H, Misaki K, Uchiyama N, Ueda F, Nakada M. Inflow Jet Patterns of Unruptured Cerebral Aneurysms Based on the Flow Velocity in the Parent Artery: Evaluation Using 4D Flow MRI. AJNR Am J Neuroradiol 2016; 37:1318-23. [PMID: 26892984 DOI: 10.3174/ajnr.a4704] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2015] [Accepted: 12/16/2015] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE Inflow jet characteristics may be related to aneurysmal bleb formation and rupture. We investigated the visualization threshold on the basis of the flow velocity in the parent artery to classify the inflow jet patterns observed on 4D flow MR imaging. MATERIALS AND METHODS Fifty-seven unruptured aneurysms (24 bifurcation and 33 sidewall aneurysms) were subjected to 4D flow MR imaging to visualize inflow streamline bundles whose velocity exceeded visualization thresholds corresponding to 60%, 75%, and 90% of the maximum flow velocity in the parent artery. The shape of the streamline bundle was determined visually, and the inflow jet patterns were classified as concentrated, diffuse, neck-limited, and unvisualized. RESULTS At the 75% threshold, bifurcation aneurysms exhibited a concentrated inflow jet pattern at the highest rate. At this threshold, the inflow jets were concentrated in 13 aneurysms (group C, 22.8%), diffuse in 18 (group D, 31.6%), neck-limited in 11 (group N, 19.3%), and unvisualized in 15 (group U, 26.3%). In 16 (28.1%) of the 57 aneurysms, the inflow jet pattern was different at various thresholds. Most inflow parameters, including the maximum inflow velocity and rate, the inflow velocity ratio, and the inflow rate ratio, were significantly higher in groups C and D than in groups N and U. CONCLUSIONS The inflow jet pattern may depend on the threshold applied to visualize the inflow streamlines on 4D flow MR imaging. For the classification of the inflow jet patterns on 4D flow MR imaging, the 75% threshold may be optimal among the 3 thresholds corresponding to 60%, 75%, and 90% of the maximum flow velocity in the parent artery.
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Affiliation(s)
- K Futami
- From the Department of Neurosurgery, Mattoh-Ishikawa Central Hospital (K.F.), Ishikawa, Japan
| | - T Kitabayashi
- Departments of Neurosurgery (T.K., H.S., K.M., N.U., M.N.)
| | - H Sano
- Departments of Neurosurgery (T.K., H.S., K.M., N.U., M.N.)
| | - K Misaki
- Departments of Neurosurgery (T.K., H.S., K.M., N.U., M.N.)
| | - N Uchiyama
- Departments of Neurosurgery (T.K., H.S., K.M., N.U., M.N.)
| | - F Ueda
- Radiology (F.U.), Kanazawa University School of Medicine, Ishikawa, Japan
| | - M Nakada
- Departments of Neurosurgery (T.K., H.S., K.M., N.U., M.N.)
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Yang H, Zhu Y, Geng Z, Li C, Zhou L, Liu QI. Clinical value of black-blood high-resolution magnetic resonance imaging for intracranial atherosclerotic plaques. Exp Ther Med 2015; 10:231-236. [PMID: 26170940 DOI: 10.3892/etm.2015.2469] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2014] [Accepted: 03/20/2015] [Indexed: 11/05/2022] Open
Abstract
The present study evaluated the value of black-blood high-resolution magnetic resonance imaging (HRMRI) for the visualization of intracranial atherosclerosis (ICAS) plaques. A total of 110 patients with cerebral artery or vertebrobasilar stenosis, vessel occlusion or a significantly weakened signal in black-blood magnetic resonance angiography (MRA; three-dimensional time-of-flight) were examined. Black-blood MRA was used to observe whether plaques were present in the abnormal vascular walls. Among the 110 patients with cerebral infarction, 16 cases presented with no significant abnormality of the lumen and walls, while plaques were observed in 94 cases. The plaques were categorized according to their signal characteristics, which resulted in the identification of four cases of type I and II plaques, 15 cases of type III, 26 cases of type IV and V, 23 cases of type VI, 11 cases of type VII, 14 cases of type VIII and one case of a mixed plaque. In summary, 3.0 T black-blood HRMRI was demonstrated to objectively exhibit characteristics of various types of ICAS plaques. Therefore, this imaging technique may be applied as a key method for the clinical non-invasive determination of ICAS plaques.
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Affiliation(s)
- Haiqing Yang
- Department of Radiology, The Second Hospital of Hebei Medical University, Shijiazhuang, Hebei 050000, P.R. China
| | - Yifei Zhu
- Department of Neurology, The Second Hospital of Hebei Medical University, Shijiazhuang, Hebei 050000, P.R. China
| | - Zuojun Geng
- Department of Radiology, The Second Hospital of Hebei Medical University, Shijiazhuang, Hebei 050000, P.R. China
| | - Caiying Li
- Department of Radiology, The Second Hospital of Hebei Medical University, Shijiazhuang, Hebei 050000, P.R. China
| | - Lixia Zhou
- Department of Radiology, The Second Hospital of Hebei Medical University, Shijiazhuang, Hebei 050000, P.R. China
| | - Q I Liu
- Department of Neurology, The Second Hospital of Hebei Medical University, Shijiazhuang, Hebei 050000, P.R. China
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12
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Anderson JR, Thompson WL, Alkattan AK, Diaz O, Klucznik R, Zhang YJ, Britz GW, Grossman RG, Karmonik C. Three-dimensional printing of anatomically accurate, patient specific intracranial aneurysm models. J Neurointerv Surg 2015; 8:517-20. [PMID: 25862767 DOI: 10.1136/neurintsurg-2015-011686] [Citation(s) in RCA: 66] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2015] [Accepted: 03/23/2015] [Indexed: 11/04/2022]
Abstract
OBJECTIVE To develop and validate a method for creating realistic, patient specific replicas of cerebral aneurysms by means of fused deposition modeling. METHODS The luminal boundaries of 10 cerebral aneurysms, together with adjacent proximal and distal sections of the parent artery, were segmented based on DSA images, and corresponding virtual three-dimensional (3D) surface reconstructions were created. From these, polylactic acid and MakerBot Flexible Filament replicas of each aneurysm were created by means of fused deposition modeling. The accuracy of the replicas was assessed by quantifying statistical significance in the variations of their inner dimensions relative to 3D DSA images. Feasibility for using these replicas as flow phantoms in combination with phase contrast MRI was demonstrated. RESULTS 3D printed aneurysm models were created for all 10 subjects. Good agreement was seen between the models and the source anatomy. Aneurysm diameter measurements of the printed models and source images correlated well (r=0.999; p<0.001), with no statistically significant group difference (p=0.4) or observed bias. The SDs of the measurements were 0.5 mm and 0.2 mm for source images and 3D models, respectively. 3D printed models could be imaged with flow via MRI. CONCLUSIONS The 3D printed aneurysm models presented were accurate and were able to be produced inhouse. These models can be used for previously cited applications, but their anatomical accuracy also enables their use as MRI flow phantoms for comparison with ongoing studies of computational fluid dynamics. Proof of principle imaging experiments confirm MRI flow phantom utility.
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Affiliation(s)
- Jeff R Anderson
- MRI Core, Houston Methodist Research Institute, Houston, Texas, USA
| | | | | | - Orlando Diaz
- Cerebrovascular Center, Houston Methodist Hospital, Houston, Texas, USA Department of Neurosurgery, Houston Methodist Hospital, Houston, Texas, USA
| | - Richard Klucznik
- Cerebrovascular Center, Houston Methodist Hospital, Houston, Texas, USA Department of Neurosurgery, Houston Methodist Hospital, Houston, Texas, USA
| | - Yi J Zhang
- Cerebrovascular Center, Houston Methodist Hospital, Houston, Texas, USA Department of Neurosurgery, Houston Methodist Hospital, Houston, Texas, USA
| | - Gavin W Britz
- Cerebrovascular Center, Houston Methodist Hospital, Houston, Texas, USA Department of Neurosurgery, Houston Methodist Hospital, Houston, Texas, USA
| | - Robert G Grossman
- Department of Neurosurgery, Houston Methodist Hospital, Houston, Texas, USA
| | - Christof Karmonik
- MRI Core, Houston Methodist Research Institute, Houston, Texas, USA Cerebrovascular Center, Houston Methodist Hospital, Houston, Texas, USA Department of Neurosurgery, Houston Methodist Hospital, Houston, Texas, USA
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13
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Futami K, Sano H, Kitabayashi T, Misaki K, Nakada M, Uchiyama N, Ueda F. Parent artery curvature influences inflow zone location of unruptured sidewall internal carotid artery aneurysms. AJNR Am J Neuroradiol 2014; 36:342-8. [PMID: 25234030 DOI: 10.3174/ajnr.a4122] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE Future aneurysmal behaviors or treatment outcomes of cerebral aneurysms may be related to the hemodynamics around the inflow zone. Here we investigated the influence of parent artery curvature on the inflow zone location of unruptured sidewall internal carotid artery aneurysms. MATERIALS AND METHODS In 32 aneurysms, the inflow zone location was decided by 4D flow MR imaging, and the radius of the parent artery curvature was measured in 2D on an en face image of the section plane corresponding to the aneurysm orifice. RESULTS The inflow zone was on the distal neck in 10 (group 1, 31.3%), on the lateral side in 19 (group 2, 59.4%), and on the proximal neck in 3 (group 3, 9.4%) aneurysms. The radius in group 1 was significantly larger than that in group 2 (8.3 mm [4.5 mm] versus 4.5 mm [1.9 mm]; median [interquartile range]; P < .0001). All 7 aneurysms with a radius of >8.0 mm were in group 1. All 18 aneurysms with a radius of <6.0 mm were in group 2 or 3. In two group 3 aneurysms, the inflow zone was located in a part of the neck extending beyond the central axis of the parent artery. CONCLUSIONS The inflow zone locations of sidewall aneurysms can be influenced by the parent artery curvature evaluated in 2D on an en face image of the section plane corresponding to the aneurysm orifice.
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Affiliation(s)
- K Futami
- From the Department of Neurosurgery (K.F.), Mattoh-Ishikawa Central Hospital, Ishikawa, Japan
| | - H Sano
- Departments of Neurosurgery (H.S., T.K., K.M., M.N., N.U.)
| | - T Kitabayashi
- Departments of Neurosurgery (H.S., T.K., K.M., M.N., N.U.)
| | - K Misaki
- Departments of Neurosurgery (H.S., T.K., K.M., M.N., N.U.)
| | - M Nakada
- Departments of Neurosurgery (H.S., T.K., K.M., M.N., N.U.)
| | - N Uchiyama
- Departments of Neurosurgery (H.S., T.K., K.M., M.N., N.U.)
| | - F Ueda
- Radiology (F.U.), Kanazawa University School of Medicine, Ishikawa, Japan
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