Journal article
Insights into the pathogenesis of cerebral fusiform aneurysms: high-resolution MRI and computational analysis
Journal of neurointerventional surgery, Vol.13(12), pp.1180-1186
02/25/2021
DOI: 10.1136/neurintsurg-2020-017243
PMID: 33632878
Abstract
Background Intracranial fusiform aneurysms are complex and poorly characterized vascular lesions. High-resolution magnetic resonance imaging (HR-MRI) and computational morphological analysis may be used to characterize cerebral fusiform aneurysms.
Objective To use advanced imaging and computational analysis to understand the unique pathophysiology, and determine possible underlying mechanisms of instability of cerebral fusiform aneurysms.
Methods Patients with unruptured intracranial aneurysms prospectively underwent imaging with 3T HR-MRI at diagnosis. Aneurysmal wall enhancement was objectively quantified using signal intensity after normalization of the contrast ratio (CR) with the pituitary stalk. Enhancement between saccular and fusiform aneurysms was compared, as well as enhancement characteristics of fusiform aneurysms. The presence of microhemorrhages in fusiform aneurysms was determined with quantitative susceptibility mapping (QSM). Three distinct types of fusiform aneurysms were analyzed with computational fluid dynamics (CFD) and finite element analysis (FEA).
Results A total of 130 patients with 160 aneurysms underwent HR-MRI. 136 aneurysms were saccular and 24 were fusiform. Fusiform aneurysms had a significantly higher CR and diameter than saccular aneurysms. Enhancing fusiform aneurysms exhibited more enhancement of reference vessels than non-enhancing fusiform aneurysms. Ten fusiform aneurysms underwent QSM analysis, and five aneurysms showed microhemorrhages. Microhemorrhage-positive aneurysms had a larger volume, diameter, and greater enhancement than aneurysms without microhemorrhage. Three types of fusiform aneurysms exhibited different CFD and FEA patterns.
Conclusion Fusiform aneurysms exhibited more contrast enhancement than saccular aneurysms. Enhancing fusiform aneurysms had larger volume and diameter, more enhancement of reference vessels, and more often exhibited microhemorrhage than non-enhancing aneurysms. CFD and FEA suggest that various pathophysiological processes determine the formation and growth of fusiform aneurysms.
Details
- Title: Subtitle
- Insights into the pathogenesis of cerebral fusiform aneurysms: high-resolution MRI and computational analysis
- Creators
- Ryan Phillip Sabotin - Department of Neurology, The University of Iowa Hospitals and Clinics, Iowa City, Iowa, USAAlberto Varon - Department of Neurology, The University of Iowa, Iowa City, Iowa, USAJorge A Roa - Department of Neurology, The University of Iowa Hospitals and Clinics, Iowa City, Iowa, USAAshrita Raghuram - Department of Neurology, The University of Iowa Hospitals and Clinics, Iowa City, Iowa, USADaizo Ishii - Department of Neurosurgery, The University of Iowa Hospitals and Clinics, Iowa City, Iowa, USAMarco Nino - Roy J Carver Department of Biomedical Engineering, The University of Iowa, Iowa City, Iowa, USAAdam E Galloy - Roy J Carver Department of Biomedical Engineering, The University of Iowa, Iowa City, Iowa, USADevanshee Patel - Department of Neurology, The University of Iowa Hospitals and Clinics, Iowa City, Iowa, USAMadhavan L Raghavan - Roy J Carver Department of Biomedical Engineering, The University of Iowa, Iowa City, Iowa, USADavid Hasan - Department of Neurosurgery, The University of Iowa Hospitals and Clinics, Iowa City, Iowa, USAEdgar A Samaniego - Department of Radiology, The University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA
- Resource Type
- Journal article
- Publication Details
- Journal of neurointerventional surgery, Vol.13(12), pp.1180-1186
- DOI
- 10.1136/neurintsurg-2020-017243
- PMID
- 33632878
- ISSN
- 1759-8478
- eISSN
- 1759-8486
- Grant note
- name: Bee Foundation, award: 2019 Brain Aneurysm Research Grant; name: Society of Vascular and Interventional Neurology, award: Pilot Research Grant
- Language
- English
- Date published
- 02/25/2021
- Academic Unit
- Roy J. Carver Department of Biomedical Engineering; Neurology; Radiology; Iowa Neuroscience Institute; Neurosurgery; Otolaryngology
- Record Identifier
- 9984070610902771
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