Three-dimensional hemodynamics in intracranial aneurysms: influence of size and morphology

Purpose To use four‐dimensional (4D)‐flow MRI for the comprehensive in vivo analysis of hemodynamics and its relationship to size and morphology of different intracranial aneurysms (IA). We hypothesize that different IA groups, defined by size and morphology, exhibit different velocity fields, wall...

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Published in:Journal of magnetic resonance imaging 2014-01, Vol.39 (1), p.120-131
Main Authors: Schnell, Susanne, Ansari, Sameer A., Vakil, Parmede, Wasielewski, Marie, Carr, Maria L., Hurley, Michael C., Bendok, Bernard R., Batjer, Hunt, Carroll, Timothy J., Carr, James, Markl, Michael
Format: Article
Language:English
Subjects:
4D-flow MRI
Adult
Age
Aged
Aged, 80 and over
Aneurysm
Blood Flow Velocity
Cohort Studies
Female
Hemodynamics
Humans
Imaging, Three-Dimensional
Intracranial Aneurysm - diagnosis
intracranial aneurysms
Magnetic Resonance Imaging
Male
Middle Aged
Models, Cardiovascular
Reproducibility of Results
Shear Strength
Stress, Mechanical
velocity
vorticity
WSS
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Summary:Purpose To use four‐dimensional (4D)‐flow MRI for the comprehensive in vivo analysis of hemodynamics and its relationship to size and morphology of different intracranial aneurysms (IA). We hypothesize that different IA groups, defined by size and morphology, exhibit different velocity fields, wall shear stress, and vorticity. Materials and Methods The 4D‐flow MRI (spatial resolution = 0.99–1.8 × 0.78–1.46 × 1.2–1.4 mm3, temporal resolution = 44–48 ms) was performed in 19 IAs (18 patients, age = 55.4 ± 13.8 years) with saccular (n = 16) and fusiform (n = 3) morphology and different sizes ranging from small (n = 8; largest dimension = 6.2 ± 0.4 mm) to large and giant (n = 11; 25 ± 7 mm). Analysis included quantification of volumetric spatial–temporal velocity distribution, vorticity, and wall shear stress (WSS) along the aneurysm's 3D surface. Results The 4D‐flow MRI revealed distinct hemodynamic patterns for large/giant saccular aneurysms (Group 1), small saccular aneurysms (Group 2), and large/giant fusiform aneurysms (Group 3). Saccular IA (Groups 1, 2) demonstrated significantly higher peak velocities (P < 0.002) and WSS (P < 0.001) compared with fusiform aneurysms. Although intra‐aneurysmal 3D velocity distributions were similar for Group 1 and 2, vorticity and WSS was significantly (P < 0.001) different (increased in Group 1 by 54%) indicating a relationship between IA size and hemodynamics. Group 3 showed reduced velocities (P < 0.001) and WSS (P < 0.001). Conclusion The 4D‐flow MRI demonstrated the influence of lesion size and morphology on aneurysm hemodynamics suggesting the potential of 4D‐flow MRI to assist in the classification of individual aneurysms. J. Magn. Reson. Imaging 2014;39:120–131. © 2013 Wiley Periodicals, Inc.
ISSN:1053-1807
1522-2586
DOI:10.1002/jmri.24110