title: Morphological and hemodynamic analysis of mirror posterior communicating artery aneurysms.
abstract: OBJECTIVE
  Hemodynamic factors are commonly believed to play an important role in the pathogenesis, progression, and rupture of cerebral aneurysms. In this study, we aimed to identify significant hemodynamic and morphological parameters that discriminate intracranial aneurysm rupture status using 3-dimensional-angiography and computational fluid dynamics technology.
  
  
  METHODS
  3D-DSA was performed in 8 patients with mirror posterior communicating artery aneurysms (Pcom-MANs). Each pair was divided into ruptured and unruptured groups. Five morphological and three hemodynamic parameters were evaluated for significance with respect to rupture.
  
  
  RESULTS
  The normalized mean wall shear stress (WSS) of the aneurysm sac in the ruptured group was significantly lower than that in the unruptured group (0.52±0.20 versus 0.81±0.21, P = .012). The percentage of the low WSS area in the ruptured group was higher than that in the unruptured group (4.11±4.66% versus 0.02±0.06%, P = .018). The AR was 1.04±0.21 in the ruptured group, which was significantly higher than 0.70±0.17 in the unruptured group (P = .012). By contrast, parameters that had no significant differences between the two groups were OSI (P = .674), aneurysm size (P = .327), size ratio (P = .779), vessel angle (P = 1.000) and aneurysm inclination angle (P = 1.000).
  
  
  CONCLUSIONS
  Pcom-MANs may be a useful disease model to investigate possible causes of aneurysm rupture. The ruptured aneurysms manifested lower WSS, higher percentage of low WSS area, and higher AR, compared with the unruptured one. And hemodynamics is as important as morphology in discriminating aneurysm rupture status.
authors: Department of Neurosurgery, Changhai Hospital, Second Military Medical University, Shanghai, China.
authors: Jinyu
authors: J
authors: Xu
authors: Ying
authors: Y
authors: Yu
authors: Xi
authors: X
authors: Wu
authors: Yongfa
authors: Y
authors: Wu
authors: Che
authors: C
authors: Jiang
authors: Shengzhang
authors: S
authors: Wang
authors: Qinghai
authors: Q
authors: Huang
authors: Jianmin
authors: J
authors: Liu
mesh_terms: D000792:Angiography / Q000379:methods*; D001696:Biomechanical Phenomena; D002681:China; D006439:Hemodynamics / Q000502:physiology*; D006801:Humans; D021621:Imaging, Three-Dimensional / Q000379:methods; D002532:Intracranial Aneurysm / Q000473:pathology* / Q000503:physiopathology*; D008955:Models, Cardiovascular; D011673:Pulsatile Flow / Q000502:physiology; D033081:Shear Strength
references: Stroke. 2011 Jan;42(1):144-52
references: 21106956
references: Stroke. 2008 Nov;39(11):2997-3002
references: 18688012
references: J Neurosurg. 2005 Oct;103(4):662-80
references: 16266049
references: Lancet. 2003 Jul 12;362(9378):103-10
references: 12867109
references: J Neurosurg. 1990 Jul;73(1):37-47
references: 2191091
references: J Neurosurg. 2005 Feb;102(2):355-62
references: 15739566
references: Neurosurgery. 2009 Apr;64(4):622-30; discussion 630-1
references: 19349824
references: J R Soc Interface. 2012 Apr 7;9(69):677-88
references: 21957117
references: J Neurosurg. 2004 Oct;101(4):676-81
references: 15481725
references: AJNR Am J Neuroradiol. 2011 Mar;32(3):595-601
references: 21273353
references: IEEE Trans Med Imaging. 2005 Apr;24(4):457-67
references: 15822804
references: AJNR Am J Neuroradiol. 2008 Oct;29(9):1761-7
references: 18599576
references: Neurosurgery. 1999 Jul;45(1):119-29; discussion 129-30
references: 10414574
references: AJNR Am J Neuroradiol. 2011 Aug;32(7):1255-61
references: 21757526
references: Surg Neurol. 2006 Jan;65(1):18-25; discussion 25-7
references: 16378842
references: Neurosurgery. 2005 Oct;57(4):676-83; discussion 676-83
references: 16239879
references: J Neuroradiol. 2003 Dec;30(5):336-50
references: 14752379
references: J Biomech Eng. 1996 Feb;118(1):74-82
references: 8833077
references: J Biomech. 2011 Nov 10;44(16):2809-16
references: 21925661
references: Acta Neurochir (Wien). 2009 Dec;151(12):1569-74
references: 19415178
references: Neurosurgery. 2001 Mar;48(3):495-502; discussion 502-3
references: 11270538
references: Stroke. 2010 Jul;41(7):1423-30
references: 20508183
references: Stroke. 2004 Nov;35(11):2500-5
references: 15514200
references: AJNR Am J Neuroradiol. 2011 Jan;32(1):145-51
references: 21127144
references: AJNR Am J Neuroradiol. 2005 Nov-Dec;26(10):2550-9
references: 16286400
references: J Neurosurg. 2003 Sep;99(3):447-51
references: 12959428
references: AJNR Am J Neuroradiol. 2009 Feb;30(2):297-302
references: 19131411
references: Arch Neurol. 1984 Nov;41(11):1142-6
references: 6487096
references: Neurosurgery. 2008 Aug;63(2):185-96; discussion 196-7
references: 18797347