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Correlation of Inflow Velocity Ratio Detected by Phase Contrast Magnetic Resonance Angiography with the Bleb Color of Unruptured Intracranial Aneurysms
- Source :
- World Neurosurgery: X, Vol 10, Iss, Pp 100098-(2021), World Neurosurgery: X
- Publication Year :
- 2021
- Publisher :
- Elsevier BV, 2021.
-
Abstract
- Background Intraoperative rupture is the most fatal and catastrophic complication of surgery for unruptured intracranial aneurysms (UIAs); thus, it is extremely useful to predict reddish and thin-walled regions of the UIA before surgery. Although several studies have reported a relationship between the hemodynamic characteristics and intracranial aneurysm wall thickness, a consistent opinion is lacking. We aimed to investigate the relationship between objectively and quantitatively evaluated bleb wall color and hemodynamic characteristics using phase-contrast magnetic resonance angiography (PC-MRA). Methods Ten patients diagnosed with UIA who underwent surgical clipping and preoperative magnetic resonance imaging along with PC-MRA were included in this study. Bleb wall color was evaluated from an intraoperative video. Based on the Red (R), Green, and Blue values, bleb wall redness (modified R value; mR) was calculated and compared with the hemodynamic characteristics obtained from PC-MRA. Results The wall redness distribution of 18 blebs in 11 UIAs in 10 patients was analyzed. Bleb/neck inflow velocity ratio (Vb/Va: r = 0.66, P = 0.003) strongly correlated with mR, whereas bleb/neck inflow rate ratio (r = 0.58, P = 0.012) correlated moderately. Multivariate regression analysis revealed that only Vb/Va (P = 0.017) significantly correlated with mR. There was no correlation between wall shear stress and mR. Conclusions The bleb redness of UIAs and Vb/Va, calculated using PC-MRA, showed a significantly greater correlation. Thus, it is possible to predict bleb thickness noninvasively before surgery. This will facilitate more detailed pre- and intraoperative strategies for clipping and coiling for safe surgery.
- Subjects :
- MRI, Magnetic resonance imaging
genetic structures
medicine.medical_treatment
lcsh:Surgery
Hemodynamics
RRT, Relative residence time
lcsh:RC346-429
Magnetic resonance angiography
mR, Modified R value
Va, Inflow velocity of the aneurysm
Aneurysm
UIAs, Unruptured intracranial aneurysms
Qb/Qa, Bleb/neck inflow rate ratio
3D, 3-dimensional
medicine
WSS, Wall shear stress
TIWRs, Thin-walled regions
Bleb (cell biology)
Inflow velocity
Unruptured intracranial aneurysm
lcsh:Neurology. Diseases of the nervous system
Bleb
Wall thickness
medicine.diagnostic_test
Inflow velocity ratio
business.industry
Qa, Inflow rate of the aneurysm
PC-MRA, Phase-contrast magnetic resonance angiography
Magnetic resonance imaging
lcsh:RD1-811
Clipping (medicine)
CFD, Computational fluid dynamics
TOF, Time-of-flight
Vb/Va, Bleb/neck inflow velocity ratio
medicine.disease
Phase contrast magnetic resonance angiography
eye diseases
RGB, Baseline red, green, and blue
Vb, Inflow velocity of the bled
Qb, Inflow rate of the bleb
Original Article
Surgery
Neurology (clinical)
Complication
business
Nuclear medicine
Subjects
Details
- ISSN :
- 25901397
- Volume :
- 10
- Database :
- OpenAIRE
- Journal :
- World Neurosurgery: X
- Accession number :
- edsair.doi.dedup.....6329e3db933c66237c12bd8db984fc57