Hemodynamic Parameters in the Parent Arteries of Unruptured Intracranial Aneurysms Depend on Aneurysm Size and Are Different Compared to Contralateral Arteries: A 7 Tesla 4D Flow MRI Study

Author:

van Tuijl Rick J.12ORCID,Timmins Kimberley M.1,Velthuis Birgitta K.1,van Ooij Pim3,Zwanenburg Jaco J.M.12,Ruigrok Ynte M.4,van der Schaaf Irene C.1

Affiliation:

1. Department of Radiology University Medical Center Utrecht Utrecht The Netherlands

2. Center for Image Sciences University Medical Center Utrecht Utrecht The Netherlands

3. Department of Pediatric Cardiology University Medical Center Utrecht Utrecht The Netherlands

4. Department of Neurology and Neurosurgery, UMC Utrecht Brain Center University Medical Center Utrecht, Utrecht University Utrecht The Netherlands

Abstract

BackgroundDifferent Circle of Willis (CoW) variants have variable prevalences of aneurysm development, but the hemodynamic variation along the CoW and its relation to presence and size of unruptured intracranial aneurysms (UIAs) are not well known.PurposeGain insight into hemodynamic imaging markers of the CoW for UIA development by comparing these outcomes to the corresponding contralateral artery without an UIA using 4D flow magnetic resonance imaging (MRI).Study TypeRetrospective, cross‐sectional study.SubjectsThirty‐eight patients with an UIA, whereby 27 were women and a mean age of 62 years old.Field Strength/SequenceFour‐dimensional phase‐contrast (PC) MRI with a 3D time‐resolved velocity encoded gradient echo sequence at 7 T.AssessmentHemodynamic parameters (blood flow, velocity pulsatility index [vPI], mean velocity, distensibility, and wall shear stress [peak systolic (WSSMAX), and time‐averaged (WSSMEAN)]) in the parent artery of the UIA were compared to the corresponding contralateral artery without an UIA and were related to UIA size.Statistical TestsPaired t‐tests and Pearson Correlation tests. The threshold for statistical significance was P < 0.05 (two‐tailed).ResultsBlood flow, mean velocity, WSSMAX, and WSSMEAN were significantly higher, while vPI was lower, in the parent artery relative to contralateral artery. The WSSMAX of the parent artery significantly increased linearly while the WSSMEAN decreased linearly with increasing UIA size.ConclusionsHemodynamic parameters and WSS differ between parent vessels of UIAs and corresponding contralateral vessels. WSS correlates with UIA size, supporting a potential hemodynamic role in aneurysm pathology.Level of Evidence2Technical EfficacyStage 2

Funder

Heart Foundation

Publisher

Wiley

Subject

Radiology, Nuclear Medicine and imaging

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