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Inflow hemodynamics evaluated by using four-dimensional flow magnetic resonance imaging and the size ratio of unruptured cerebral aneurysms

  • Interventional Neuroradiology
  • Published:
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Abstract

Purpose

Prediction of the rupture risk is critical for the identification of unruptured cerebral aneurysms (UCAs) eligible for invasive treatments. The size ratio (SR) is a strong morphological predictor for rupture. We investigated the relationship between the inflow hemodynamics evaluated on four-dimensional (4D) flow magnetic resonance (MR) imaging and the SR to identify specific characteristics related to UCA rupture.

Methods

We evaluated the inflow jet patterns and inflow hemodynamic parameters of 70 UCAs on 4D flow MR imaging and compared them among 23 aneurysms with an SR ≧2.1 and 47 aneurysms with an SR ≦2.0. Based on the shape of inflow streamline bundles with a velocity ≧75% of the maximum flow velocity in the parent artery, the inflow jet patterns were classified as concentrated (C), diffuse (D), neck-limited (N), and unvisualized (U).

Results

The incidence of patterns C and N was significantly higher in aneurysms with an SR ≧2.1. The rate of pattern U was significantly higher in aneurysms with an SR ≦2.0. The maximum inflow rate and the inflow rate ratio were significantly higher in aneurysms with an SR ≧2.1.

Conclusions

The SR affected the inflow jet pattern, the maximum inflow rate, and the inflow rate ratio of UCAs. In conjunction with the SR, inflow hemodynamic analysis using 4D flow MR imaging may contribute to the risk stratification for aneurysmal rupture.

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Abbreviations

ICA:

Internal carotid artery

MR:

Magnetic resonance

SR:

Size ratio

TOF:

Time-of-flight

UCA:

Unruptured cerebral aneurysm

3D:

Three-dimensional

4D:

Four-dimensional

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Authors and Affiliations

  1. Department of Neurosurgery, Matto-Ishikawa Central Hospital, 3-8 Kuramitsu, Hakusan, Ishikawa, 920-8588, Japan

    Kazuya Futami

  2. Department of Neurosurgery, Kanazawa University School of Medicine, Kanazawa, Ishikawa, Japan

    Iku Nambu, Tomohiro Kitabayashi, Hiroki Sano, Kouichi Misaki, Naoyuki Uchiyama & Mitsutoshi Nakada

Authors
  1. Kazuya Futami
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  2. Iku Nambu
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  3. Tomohiro Kitabayashi
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  4. Hiroki Sano
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  5. Kouichi Misaki
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  6. Naoyuki Uchiyama
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  7. Mitsutoshi Nakada
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Correspondence to Kazuya Futami.

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No funding was received for this study.

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The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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Futami, K., Nambu, I., Kitabayashi, T. et al. Inflow hemodynamics evaluated by using four-dimensional flow magnetic resonance imaging and the size ratio of unruptured cerebral aneurysms. Neuroradiology 59, 411–418 (2017). https://doi.org/10.1007/s00234-017-1801-7

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  • DOI: https://doi.org/10.1007/s00234-017-1801-7

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