RT Journal Article
SR Electronic
T1 Additional Value of Intra-Aneurysmal Hemodynamics in Discriminating Ruptured versus Unruptured Intracranial Aneurysms
JF American Journal of Neuroradiology
JO Am. J. Neuroradiol.
FD American Society of Neuroradiology
SP 1920
OP 1926
DO 10.3174/ajnr.A4397
VO 36
IS 10
A1 Schneiders, J.J.
A1 Marquering, H.A.
A1 van Ooij, P.
A1 van den Berg, R.
A1 Nederveen, A.J.
A1 Verbaan, D.
A1 Vandertop, W.P.
A1 Pourquie, M.
A1 Rinkel, G.J.E.
A1 vanBavel, E.
A1 Majoie, C.B.L.M.
YR 2015
UL http://www.ajnr.org/content/36/10/1920.abstract
AB BACKGROUND AND PURPOSE: Hemodynamics are thought to play an important role in the rupture of intracranial aneurysms. We tested whether hemodynamics, determined from computational fluid dynamics models, have additional value in discriminating ruptured and unruptured aneurysms. Such discriminative power could provide better prediction models for rupture.MATERIALS AND METHODS: A cross-sectional study was performed on patients eligible for endovascular treatment, including 55 ruptured and 62 unruptured aneurysms. Association with rupture status was tested for location, aneurysm type, and 4 geometric and 10 hemodynamic parameters. Patient-specific spatiotemporal velocities measured with phase-contrast MR imaging were used as inflow conditions for computational fluid dynamics. To assess the additional value of hemodynamic parameters, we performed 1 univariate and 2 multivariate analyses: 1 traditional model including only location and geometry and 1 advanced model that included patient-specific hemodynamic parameters.RESULTS: In the univariate analysis, high-risk locations (anterior cerebral arteries, posterior communicating artery, and posterior circulation), daughter sacs, unstable inflow jets, impingements at the aneurysm body, and unstable complex flow patterns were significantly present more often in ruptured aneurysms. In both multivariate analyses, only the high-risk location (OR, 3.92; 95% CI, 1.77–8.68) and the presence of daughter sacs (OR, 2.79; 95% CI, 1.25–6.25) remained as significant independent determinants.CONCLUSIONS: In this study population of patients eligible for endovascular treatment, we found no independent additional value of aneurysmal hemodynamics in discriminating rupture status, despite high univariate associations. Only traditional parameters (high-risk location and the presence of daughter sacs) were independently associated with ruptured aneurysms.CFDcomputational fluid dynamics3DRA3D rotational angiographyPCphase-contrast