title: In Vivo Assessment of the Impact of Regional Intracranial Atherosclerotic Lesions on Brain Arterial 3D Hemodynamics.
abstract: Intracranial atherosclerosis induces hemodynamic disturbance, which is not well-characterized, particularly in cerebral flow redistribution. We aimed to characterize the impact of regional stenotic lesions on intracranial hemodynamics by using 4D flow MR imaging.
  
  
  
  4D flow MR imaging was performed in 22 symptomatic patients (mean age, 68.4 ± 14.2 years) with intracranial stenosis (ICA,n= 7; MCA,n= 9; basilar artery,n= 6) and 10 age-appropriate healthy volunteers (mean age, 60.7 ± 8.1 years). 3D blood flow patterns were visualized by using time-integrated pathlines. Blood flow and peak velocity asymmetry indices were compared between patients and healthy volunteers in 4 prespecified arteries: ICAs, MCAs, and anterior/posterior cerebral arteries.
  
  
  
  3D blood flow pathlines demonstrated flow redistribution across cerebral arteries in patients with unilateral intracranial stenosis. For patients with ICA stenosis compared with healthy volunteers, significantly lower flow and peak velocities were identified in the ipsilateral ICA (P= .001 andP= .001) and MCA (P< .001 andP= .001), but higher flow, in the ipsilateral PCA (P< .001). For patients with MCA stenosis, significantly lower flow and peak velocities were observed in the ipsilateral ICA (P= .009 andP= .045) and MCA (P< .001 andP= .005), but significantly higher flow was found in the ipsilateral posterior cerebral artery (P= .014) and anterior cerebral artery (P= .006). The asymmetry indices were not significantly different between patients with basilar artery stenosis and the healthy volunteers.
  
  
  
  Regional intracranial atherosclerotic lesions not only alter distal arterial flow but also significantly affect ipsilateral collateral arterial hemodynamics.
authors.affiliation: From the Department of Biomedical Engineering (C.W., M.M.), McCormick School of Engineering, Northwestern University, Chicago, Illinois canwu2016@u.northwestern.edu.|Departments of Radiology (C.W., S.S., P.V., A.R.H., S.A.A., J.C., M.M.).|Philips Healthcare (C.W.), Gainesville, Florida.
authors.forename: C
authors.identifier: 0000-0003-1171-4546
authors.initials: C
authors.lastname: Wu
authors.affiliation: Departments of Radiology (C.W., S.S., P.V., A.R.H., S.A.A., J.C., M.M.).
authors.forename: S
authors.identifier: 0000-0001-6009-4756
authors.initials: S
authors.lastname: Schnell
authors.affiliation: Departments of Radiology (C.W., S.S., P.V., A.R.H., S.A.A., J.C., M.M.).
authors.forename: P
authors.identifier: 0000-0002-3862-2185
authors.initials: P
authors.lastname: Vakil
authors.affiliation: Departments of Radiology (C.W., S.S., P.V., A.R.H., S.A.A., J.C., M.M.).
authors.forename: A R
authors.identifier: 0000-0002-7491-381X
authors.initials: AR
authors.lastname: Honarmand
authors.affiliation: Departments of Radiology (C.W., S.S., P.V., A.R.H., S.A.A., J.C., M.M.).|Neurological Surgery (S.A.A.).
authors.forename: S A
authors.identifier: 0000-0001-8176-4616
authors.initials: SA
authors.lastname: Ansari
authors.affiliation: Departments of Radiology (C.W., S.S., P.V., A.R.H., S.A.A., J.C., M.M.).
authors.forename: J
authors.identifier: 0000-0001-6549-4863
authors.initials: J
authors.lastname: Carr
authors.affiliation: From the Department of Biomedical Engineering (C.W., M.M.), McCormick School of Engineering, Northwestern University, Chicago, Illinois.|Departments of Radiology (C.W., S.S., P.V., A.R.H., S.A.A., J.C., M.M.).
authors.forename: M
authors.identifier: 0000-0002-7686-1128
authors.initials: M
authors.lastname: Markl
authors.affiliation: Neurology (S.P.), Feinberg School of Medicine, Northwestern University, Chicago, Illinois.
authors.forename: S
authors.identifier: 0000-0003-0724-1694
authors.initials: S
authors.lastname: Prabhakaran
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001921:Brain / Q000098:blood supply* / Q000503:physiopathology; D002536:Cerebral Arteries / Q000473:pathology / Q000503:physiopathology*; D002560:Cerebrovascular Circulation / Q000502:physiology*; D005260:Female; D006439:Hemodynamics / Q000502:physiology*; D006801:Humans; D002537:Intracranial Arteriosclerosis / Q000473:pathology / Q000503:physiopathology*; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008875:Middle Aged; D059906:Neuroimaging / Q000379:methods