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Insights into the pathogenesis of cerebral fusiform aneurysms: high-resolution MRI and computational analysis
- Source :
- Journal of neurointerventional surgery. 13(12)
- Publication Year :
- 2020
-
Abstract
- BackgroundIntracranial 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.ObjectiveTo use advanced imaging and computational analysis to understand the unique pathophysiology, and determine possible underlying mechanisms of instability of cerebral fusiform aneurysms.MethodsPatients 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).ResultsA 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.ConclusionFusiform 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.
- Subjects :
- Pituitary stalk
medicine.medical_specialty
medicine.diagnostic_test
business.industry
Finite Element Analysis
High resolution
Magnetic resonance imaging
Quantitative susceptibility mapping
Fusiform Aneurysm
Intracranial Aneurysm
General Medicine
medicine.disease
Magnetic Resonance Imaging
Pathogenesis
Aneurysm
cardiovascular system
medicine
Humans
Surgery
cardiovascular diseases
Neurology (clinical)
Computational analysis
Radiology
business
Subjects
Details
- ISSN :
- 17598486
- Volume :
- 13
- Issue :
- 12
- Database :
- OpenAIRE
- Journal :
- Journal of neurointerventional surgery
- Accession number :
- edsair.doi.dedup.....ed0179c8902edc7c676de384a4796cb9