Wenbo Sun1, Zhao Ruan1, Xuan Dai2, Sirui Li1, Shuo Li3, Jianjian Zhang2, Jincao Chen2, Heye Zhang4, Haibo Xu5. 1. Department of Radiology, Zhongnan Hospital of Wuhan University, Wuhan University, Wuhan, China. 2. Department of Neurosurgery, Zhongnan Hospital of Wuhan University, Wuhan University, Wuhan, China. 3. Department of Medical Biophysics, University of Western Ontario, London, Ontario, Canada. 4. School of Biomedical Engineering, Sun Yat-Sen University, Guangzhou, China; Guangdong Provincial Key Laboratory of Sensor Technology and Biomedical Instrument, Guangzhou, China. Electronic address: hy.zhang@siat.ac.cn. 5. Department of Radiology, Zhongnan Hospital of Wuhan University, Wuhan University, Wuhan, China. Electronic address: xuhaibo1120@hotmail.com.
Abstract
OBJECTIVE: To investigate hemodynamic changes in moyamoya disease (MMD) via two-dimensional cine phase-contrast magnetic resonance imaging and computational fluid dynamics. METHODS: In 18 patients with MMD and 10 healthy control subjects, phase-contrast magnetic resonance imaging was performed to quantify flow rate of main supplying arteries, including internal carotid arteries (ICAs) and vertebral arteries. Mean flow rate in these vessels was adopted as the patient-specific boundary condition for computational fluid dynamics simulation of the circle of Willis in MMD and control groups. Pressure drop in both ICAs and their difference, wall shear stress and secondary flow in the carotid siphon of ICAs, and flow rate and size of posterior communicating arteries (PComAs) were compared between MMD and control groups. Four patients with MMD underwent follow-up scans for longitudinal comparison. RESULTS: Phase-contrast magnetic resonance imaging data revealed significantly different flow rate in the left ICA and right vertebral arteries between MMD and control groups. Computational fluid dynamics simulation demonstrated similar wall shear stress and similar secondary flow of both ICAs but significantly higher pressure drop in left ICA, higher pressure drop difference between left ICA and right ICA, and higher flow rate in PComAs in patients with MMD compared with control subjects. Significantly increased size of left PComA in patients with MMD was also found. Follow-up results confirmed that the combination of pressure drop difference, flow rate, and size of PComAs can potentially assist long-term prognosis after surgery. CONCLUSIONS: Pressure drop difference, flow rate, and size of PComAs can be used to evaluate impairments in cerebrovascular reserve and indicate long-term prognosis in MMD.
OBJECTIVE: To investigate hemodynamic changes in moyamoya disease (MMD) via two-dimensional cine phase-contrast magnetic resonance imaging and computational fluid dynamics. METHODS: In 18 patients with MMD and 10 healthy control subjects, phase-contrast magnetic resonance imaging was performed to quantify flow rate of main supplying arteries, including internal carotid arteries (ICAs) and vertebral arteries. Mean flow rate in these vessels was adopted as the patient-specific boundary condition for computational fluid dynamics simulation of the circle of Willis in MMD and control groups. Pressure drop in both ICAs and their difference, wall shear stress and secondary flow in the carotid siphon of ICAs, and flow rate and size of posterior communicating arteries (PComAs) were compared between MMD and control groups. Four patients with MMD underwent follow-up scans for longitudinal comparison. RESULTS: Phase-contrast magnetic resonance imaging data revealed significantly different flow rate in the left ICA and right vertebral arteries between MMD and control groups. Computational fluid dynamics simulation demonstrated similar wall shear stress and similar secondary flow of both ICAs but significantly higher pressure drop in left ICA, higher pressure drop difference between left ICA and right ICA, and higher flow rate in PComAs in patients with MMD compared with control subjects. Significantly increased size of left PComA in patients with MMD was also found. Follow-up results confirmed that the combination of pressure drop difference, flow rate, and size of PComAs can potentially assist long-term prognosis after surgery. CONCLUSIONS: Pressure drop difference, flow rate, and size of PComAs can be used to evaluate impairments in cerebrovascular reserve and indicate long-term prognosis in MMD.