Hemodynamic Differences Between Recurrent and Nonrecurrent Intracranial Aneurysms: Fluid Dynamics Simulations Based on MR Angiography
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Hemodynamic Differences Between Recurrent and Nonrecurrent Intracranial Aneurysms: Fluid Dynamics Simulations Based on MR Angiography. / Schönfeld, Michael Hinrich; Forkert, Nils Daniel; Fiehler, Jens; Cho, Young Dae; Han, Moon Hee; Kang, Hyun-Seung; Peach, Thomas William; Byrne, James Vincent.
in: J NEUROIMAGING, Jahrgang 29, Nr. 4, 07.2019, S. 447-453.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
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T1 - Hemodynamic Differences Between Recurrent and Nonrecurrent Intracranial Aneurysms: Fluid Dynamics Simulations Based on MR Angiography
AU - Schönfeld, Michael Hinrich
AU - Forkert, Nils Daniel
AU - Fiehler, Jens
AU - Cho, Young Dae
AU - Han, Moon Hee
AU - Kang, Hyun-Seung
AU - Peach, Thomas William
AU - Byrne, James Vincent
N1 - © 2019 by the American Society of Neuroimaging.
PY - 2019/7
Y1 - 2019/7
N2 - BACKGROUND AND PURPOSE: Although the role of wall shear stress (WSS) in the initiation, growth, and rupture of intracranial aneurysms has been well studied, its influence on aneurysm recurrence after endovascular treatment requires further investigation. We aimed to compare WSS at necks of recurrent and nonrecurrent aneurysms.METHODS: Nine recurrent coil-embolized aneurysms were identified and matched with nine nonrecurrent aneurysms. Patient-specific vessel geometries reconstructed from follow-up 3-D time-of-flight magnetic resonance angiography were analyzed using computational fluid dynamics (CFD) simulations. Absolute WSS and the percentage of abnormally low and high WSS at the aneurysm neck compared to the near artery were measured.RESULTS: The median percentage of abnormal WSS at the aneurysm neck was 49.3% for recurrent and 34.7% for nonrecurrent aneurysms (P = .011). The area under the receiver-operating-characteristic curve for distinguishing these aneurysms according to the percentage of abnormal WSS was .86 (95% CI .62 to .98). The optimal cut-off value of 45.1% resulted in a sensitivity and a specificity of 88.89% (95% CI 51.8% to 99.7%).CONCLUSION: Our findings indicate that necks of recurrent aneurysms are exposed to abnormal WSS to a larger extent. Abnormal WSS may serve as a metric to distinguish them from nonrecurrent aneurysms with CFD simulations a priori.
AB - BACKGROUND AND PURPOSE: Although the role of wall shear stress (WSS) in the initiation, growth, and rupture of intracranial aneurysms has been well studied, its influence on aneurysm recurrence after endovascular treatment requires further investigation. We aimed to compare WSS at necks of recurrent and nonrecurrent aneurysms.METHODS: Nine recurrent coil-embolized aneurysms were identified and matched with nine nonrecurrent aneurysms. Patient-specific vessel geometries reconstructed from follow-up 3-D time-of-flight magnetic resonance angiography were analyzed using computational fluid dynamics (CFD) simulations. Absolute WSS and the percentage of abnormally low and high WSS at the aneurysm neck compared to the near artery were measured.RESULTS: The median percentage of abnormal WSS at the aneurysm neck was 49.3% for recurrent and 34.7% for nonrecurrent aneurysms (P = .011). The area under the receiver-operating-characteristic curve for distinguishing these aneurysms according to the percentage of abnormal WSS was .86 (95% CI .62 to .98). The optimal cut-off value of 45.1% resulted in a sensitivity and a specificity of 88.89% (95% CI 51.8% to 99.7%).CONCLUSION: Our findings indicate that necks of recurrent aneurysms are exposed to abnormal WSS to a larger extent. Abnormal WSS may serve as a metric to distinguish them from nonrecurrent aneurysms with CFD simulations a priori.
U2 - 10.1111/jon.12612
DO - 10.1111/jon.12612
M3 - SCORING: Journal article
C2 - 30891876
VL - 29
SP - 447
EP - 453
JO - J NEUROIMAGING
JF - J NEUROIMAGING
SN - 1051-2284
IS - 4
ER -
