BACKGROUND AND PURPOSE: Subarachnoid hemorrhage after intracranial aneurysm rupture remains a serious condition. We performed a case-control study to evaluate the use of computed hemodynamics to detect cerebral aneurysms prone to rupture. METHODS: Four patients with incidental aneurysms that ultimately ruptured (cases) were studied after initially being included in a prospective database including their 3-dimensional imaging before rupture. Ruptures were located in different arterial segments: M1 segment of the middle cerebral artery; basilar tip; posterior inferior cerebellar artery; and anterior communicating artery. For each case, 5 controls matched by location and size were randomly selected. An empirical cumulative distribution function of aneurysm wall shear stress percentiles was evaluated for every case and used to define a critical prone-to-rupture range. Univariate logistic regression analysis was then used to assess the individual risk of rupture. RESULTS: A cumulative wall shear stress distribution characterizing a hemodynamic prone-to-rupture range for small-sized aneurysms was identified and fitted independent of the location. Sensitivity and specificity of the preliminary tests were 90% and 93%, respectively. CONCLUSIONS: The wall shear stress cumulative probability function may be a potential predictor of small-sized aneurysm rupture.
BACKGROUND AND PURPOSE:Subarachnoid hemorrhage after intracranial aneurysm rupture remains a serious condition. We performed a case-control study to evaluate the use of computed hemodynamics to detect cerebral aneurysms prone to rupture. METHODS: Four patients with incidental aneurysms that ultimately ruptured (cases) were studied after initially being included in a prospective database including their 3-dimensional imaging before rupture. Ruptures were located in different arterial segments: M1 segment of the middle cerebral artery; basilar tip; posterior inferior cerebellar artery; and anterior communicating artery. For each case, 5 controls matched by location and size were randomly selected. An empirical cumulative distribution function of aneurysm wall shear stress percentiles was evaluated for every case and used to define a critical prone-to-rupture range. Univariate logistic regression analysis was then used to assess the individual risk of rupture. RESULTS: A cumulative wall shear stress distribution characterizing a hemodynamic prone-to-rupture range for small-sized aneurysms was identified and fitted independent of the location. Sensitivity and specificity of the preliminary tests were 90% and 93%, respectively. CONCLUSIONS: The wall shear stress cumulative probability function may be a potential predictor of small-sized aneurysm rupture.
Authors: M J Gounis; I M J van der Bom; A K Wakhloo; S Zheng; J-Y Chueh; A L Kühn; A A Bogdanov Journal: AJNR Am J Neuroradiol Date: 2014-10-01 Impact factor: 3.825
Authors: O Brina; R Ouared; O Bonnefous; F van Nijnatten; P Bouillot; P Bijlenga; K Schaller; K-O Lovblad; T Grünhagen; D Ruijters; V Mendes Pereira Journal: AJNR Am J Neuroradiol Date: 2014-07-31 Impact factor: 3.825