Characterization of Maximum Wall Shear Stress Points in Unruptured Cerebral Aneurysms Using Four-dimensional Flow Magnetic Resonance Imaging

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Publicat a:Clinical Neuroradiology vol. 34, no. 4 (Dec 2024), p. 899
Autor principal: Futami, Kazuya
Altres autors: Misaki, Kouichi, Uno, Takehiro, Nambu, Iku, Kamide, Tomoya, Nakada, Mitsutoshi
Publicat:
Springer Nature B.V.
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Accés en línia:Citation/Abstract
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Resum:BackgroundMaximum wall shear stress (maxWSS) points of unruptured cerebral aneurysms (UCAs) may cause wall remodeling leading to rupture. We characterized maxWSS points and their inherent intra-aneurysmal flow structures in a sizable cohort of saccular UCAs using four-dimensional (4D) flow magnetic resonance imaging (MRI).MethodsAfter contrast administration, 50 saccular UCAs were subjected to 4D flow MRI using a 1.5 T MRI scanner. Post-processing of obtained data was performed using commercially available software. The maxWSS points and maxWSS values were evaluated. The maxWSS values were statistically compared between aneurysm groups.ResultsThe maxWSS point was located on the aneurysm apex in 9 (18.0%), body in 2 (4.0%), and neck in 39 (78.0%) UCAs. The inherent intra-aneurysmal flow structure of the maxWSS point was an inflow zone in 34 (68.0%) UCAs, an inflow jet in 8 (16.0%), and an impingement zone in 8 (16.0%). The maxWSS point on the neck had significantly higher maxWSS values than those points on the other wall areas (P = 0.008). The maxWSS values of the maxWSS points on the apex and on the impingement zone were not significantly different compared with those of the other maxWSS points.ConclusionThe maxWSS points existed preferentially on the aneurysmal neck adjacent to the inflow zone with higher maxWSS values. The maxWSS points existed occasionally on the aneurysmal apex adjacent to the impingement zone. 4D flow MRI may be helpful to discriminate saccular UCAs with higher-risk maxWSS points that can cause wall remodeling leading to rupture.
ISSN:1869-1439
1869-1447
0939-7116
1615-6706
DOI:10.1007/s00062-024-01436-w
Font:Health & Medical Collection