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Hemodynamic Differences Between Recurrent and Nonrecurrent Intracranial Aneurysms: Fluid Dynamics Simulations Based on MR Angiography
Author(s) -
Schönfeld Michael Hinrich,
Forkert Nils Daniel,
Fiehler Jens,
Cho Young Dae,
Han Moon Hee,
Kang HyunSeung,
Peach Thomas William,
Byrne James Vincent
Publication year - 2019
Publication title -
journal of neuroimaging
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.822
H-Index - 64
eISSN - 1552-6569
pISSN - 1051-2284
DOI - 10.1111/jon.12612
Subject(s) - medicine , aneurysm , angiography , radiology , magnetic resonance angiography , hemodynamics , magnetic resonance imaging , receiver operating characteristic , cardiology
ABSTRACT BACKGROUND AND PURPOSE Although the role of wall shear stress (WSS) in the initiation, growth, and rupture of intracranial aneurysms has been well studied, its influence on aneurysm recurrence after endovascular treatment requires further investigation. We aimed to compare WSS at necks of recurrent and nonrecurrent aneurysms. METHODS Nine recurrent coil‐embolized aneurysms were identified and matched with nine nonrecurrent aneurysms. Patient‐specific vessel geometries reconstructed from follow‐up 3‐D time‐of‐flight magnetic resonance angiography were analyzed using computational fluid dynamics (CFD) simulations. Absolute WSS and the percentage of abnormally low and high WSS at the aneurysm neck compared to the near artery were measured. RESULTS The median percentage of abnormal WSS at the aneurysm neck was 49.3% for recurrent and 34.7% for nonrecurrent aneurysms ( P = .011). The area under the receiver‐operating‐characteristic curve for distinguishing these aneurysms according to the percentage of abnormal WSS was .86 (95% CI .62 to .98). The optimal cut‐off value of 45.1% resulted in a sensitivity and a specificity of 88.89% (95% CI 51.8% to 99.7%). CONCLUSION Our findings indicate that necks of recurrent aneurysms are exposed to abnormal WSS to a larger extent. Abnormal WSS may serve as a metric to distinguish them from nonrecurrent aneurysms with CFD simulations a priori.

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