title: In vivo visualization and analysis of 3-D hemodynamics in cerebral aneurysms with flow-sensitized 4-D MR imaging at 3 T.
abstract: BACKGROUND
  Blood-flow patterns and wall shear stress (WSS) are considered to play a major role in the development and rupture of cerebral aneurysms. These hemodynamic aspects have been extensively studied in vitro using geometric realistic aneurysm models. The purpose of this study was to evaluate the feasibility of in vivo flow-sensitized 4-D MR imaging for analysis of intraaneurysmal hemodynamics.
  
  
  METHODS
  Five cerebral aneurysms were examined using ECG-gated, flow-sensitized 4-D MR imaging at 3 T in three patients. Postprocessing included quantification of flow velocities, visualization of time-resolved 2-D vector graphs and 3-D particle traces, vortical flow analysis, and estimation of WSS. Flow patterns were analyzed in relation to aneurysm geometry and aspect ratio.
  
  
  RESULTS
  Magnitude, spatial and temporal evolution of vortical flow differed markedly among the aneurysms. Particularly unstable vortical flow was demonstrated in a wide-necked parophthalmic ICA aneurysm (high aspect ratio). Relatively stable vortical flow was observed in aneurysms with a lower aspect ratio. Except for a wide-necked cavernous ICA aneurysm (low aspect ratio), WSS was reduced in all aneurysms and showed a high spatial variation.
  
  
  CONCLUSIONS
  In vivo flow-sensitized 4-D MR imaging can be applied to analyze complex patterns of intraaneurysmal flow. Flow patterns, distribution of flow velocities, and WSS seem to be determined by the vascular geometry of the aneurysm. Temporal and spatial averaging effects are drawbacks of the MR-based analysis of flow patterns as well as the estimation of WSS, particularly in small aneurysms. Further studies are needed to establish a direct link between definitive flow patterns and different aneurysm geometries.
authors: Department of Neuroradiology, Institute of Radiology, University Hospital Basel, Petersgraben 4, 4031 Basel, Switzerland. meckels@uhbs.ch
authors: Stephan
authors: S
authors: Meckel
authors: Aurelien F
authors: AF
authors: Stalder
authors: Francesco
authors: F
authors: Santini
authors: Ernst-Wilhelm
authors: EW
authors: Radü
authors: Daniel A
authors: DA
authors: Rüfenacht
authors: Michael
authors: M
authors: Markl
authors: Stephan G
authors: SG
authors: Wetzel
mesh_terms: D001783:Blood Flow Velocity / Q000502:physiology; D002533:Cerebral Angiography / Q000379:methods*; D002560:Cerebrovascular Circulation / Q000502:physiology*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional; D002532:Intracranial Aneurysm / Q000175:diagnosis* / Q000503:physiopathology*; D018810:Magnetic Resonance Angiography / Q000379:methods*; D008875:Middle Aged; D015203:Reproducibility of Results; D014655:Vascular Resistance / Q000502:physiology