Aichi Chien1, James Sayre, Fernando Viñuela. 1. Division of Interventional Neuroradiology, David Geffen School of Medicine at UCLA, 10833 LeConte Avenue, Box 951721, Los Angeles, CA 90095, USA. aichi@ucla.edu
Abstract
INTRODUCTION: Studies have reported a correlation between blood flow dynamics in the cardiac cycle and vascular diseases, but research to analyze the dynamic changes of flow in cerebral aneurysms is limited. This quantitative study investigates the temporal changes in flow during a cardiac cycle (flow waveform) in different regions of aneurysms and their association with aneurysm rupture. METHODS: Twelve ruptured and 29 unruptured aneurysms from the internal carotid artery-ophthalmic artery segment were studied. Patient-specific aneurysm data were implemented to simulate blood flow. The temporal flow changes at different regions of the aneurysm were recorded to compare the flow waveforms. RESULTS: In more than 60 % of the cases, peak flow in the aneurysm sac occurred after peak flow in the artery. Flow rate varied among cases and no correlation with rupture, aneurysm flow rate, and aneurysm size was found. Higher pulsatility within aneurysm sacs was found when comparing with the parent artery (P < 0.001). Pulsatility was high throughout ruptured aneurysms, but increased from neck to dome in unruptured ones (P = 0.021). Significant changes between inflow and outflow flow profile were found in unruptured aneurysms (P = 0.023), but not in ruptured aneurysms. CONCLUSION: Quantitative analysis which considers temporal blood flow changes appears to provide additional information which is not apparent from aneurysmal flow at a single time point (i.e., peak of systole). By considering the flow waveform throughout the cardiac cycle, statistically significant differences were found between ruptured and unruptured cases - for flow profile, pulsatility and timing of peak flow.
INTRODUCTION: Studies have reported a correlation between blood flow dynamics in the cardiac cycle and vascular diseases, but research to analyze the dynamic changes of flow in cerebral aneurysms is limited. This quantitative study investigates the temporal changes in flow during a cardiac cycle (flow waveform) in different regions of aneurysms and their association with aneurysm rupture. METHODS: Twelve ruptured and 29 unruptured aneurysms from the internal carotid artery-ophthalmic artery segment were studied. Patient-specific aneurysm data were implemented to simulate blood flow. The temporal flow changes at different regions of the aneurysm were recorded to compare the flow waveforms. RESULTS: In more than 60 % of the cases, peak flow in the aneurysm sac occurred after peak flow in the artery. Flow rate varied among cases and no correlation with rupture, aneurysm flow rate, and aneurysm size was found. Higher pulsatility within aneurysm sacs was found when comparing with the parent artery (P < 0.001). Pulsatility was high throughout ruptured aneurysms, but increased from neck to dome in unruptured ones (P = 0.021). Significant changes between inflow and outflow flow profile were found in unruptured aneurysms (P = 0.023), but not in ruptured aneurysms. CONCLUSION: Quantitative analysis which considers temporal blood flow changes appears to provide additional information which is not apparent from aneurysmal flow at a single time point (i.e., peak of systole). By considering the flow waveform throughout the cardiac cycle, statistically significant differences were found between ruptured and unruptured cases - for flow profile, pulsatility and timing of peak flow.
Authors: Matthew N Gwilliam; Nigel Hoggard; David Capener; Pankaj Singh; Alberto Marzo; Prashant K Verma; Iain D Wilkinson Journal: J Cereb Blood Flow Metab Date: 2009-09-16 Impact factor: 6.200
Authors: T Schubert; F Santini; A F Stalder; J Bock; S Meckel; L Bonati; M Markl; S Wetzel Journal: AJNR Am J Neuroradiol Date: 2011-04-07 Impact factor: 3.825
Authors: Christina Elizabeth Agnew; A J McCann; C J Lockhart; P K Hamilton; G E McVeigh; R C McGivern Journal: IEEE Trans Biomed Eng Date: 2010-12-06 Impact factor: 4.538
Authors: S P Ferns; J J Schneiders; M Siebes; R van den Berg; E T van Bavel; C B Majoie Journal: AJNR Am J Neuroradiol Date: 2009-09-17 Impact factor: 3.825
Authors: William Hsu; Nestor R Gonzalez; Aichi Chien; J Pablo Villablanca; Päivi Pajukanta; Fernando Viñuela; Alex A T Bui Journal: J Biomed Inform Date: 2015-03-26 Impact factor: 6.317