gms | German Medical Science

70. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC)
Joint Meeting mit der Skandinavischen Gesellschaft für Neurochirurgie

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

12.05. - 15.05.2019, Würzburg

Low wall shear stress is associated with presence of wall enhancement in vessel wall MRI of unruptured intracranial aneurysms

„Low wall shear stress“ ist assoziert mit Kontrastmittelaufnahme der Aneurysmawand in der MRT unrupturierter Aneurysmen – eine kombinierte Flussdynamik und „black blood“ MRT Analyse

Meeting Abstract

  • presenting/speaker Athanasios Petridis - Universitätsklinikum Düsseldorf, Düsseldorf, Deutschland
  • Mohammad Owais Khan - Stanford University, Cardiovascular Biomechanics Computation Lab, Stanford, CA, United States
  • Christian Rubbert - Universitätsklinikum Düsseldorf, Düsseldorf, Deutschland
  • Jan Frederick Cornelius - Heinrich-Heine-Universität, Universitätsklinikum, Klinik für Neurochirurgie, Düsseldorf, Deutschland
  • Richard Bostelmann - Heinrich-Heine-Universität, Universitätsklinikum, Klinik für Neurochirurgie, Düsseldorf, Deutschland
  • Hans-Jakob Steiger - Heinrich-Heine-Universität, Universitätsklinikum, Klinik für Neurochirurgie, Düsseldorf, Deutschland

Deutsche Gesellschaft für Neurochirurgie. 70. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit der Skandinavischen Gesellschaft für Neurochirurgie. Würzburg, 12.-15.05.2019. Düsseldorf: German Medical Science GMS Publishing House; 2019. DocV291

doi: 10.3205/19dgnc310, urn:nbn:de:0183-19dgnc3108

Veröffentlicht: 8. Mai 2019

© 2019 Petridis et al.
Dieser Artikel ist ein Open-Access-Artikel und steht unter den Lizenzbedingungen der Creative Commons Attribution 4.0 License (Namensnennung). Lizenz-Angaben siehe http://creativecommons.org/licenses/by/4.0/.


Gliederung

Text

Objective: Aneurysm wall enhancement (AWE) on Vessel wall MR imaging (VWMRI) has been suggested as an imaging biomarker for intracranial aneurysms (IAs) at higher risk of rupture. While retrospective computational fluid dynamic (CFD) studies have shown a link between hemodynamic forces and rupture status, the role of hemodynamic forces in unruptured aneurysm with AWE has not yet been investigated. We present our findings of AWE in VWMRI and associated hemodynamic forces in unruptured IAs.

Methods: Digital Subtraction Angiography (DSA) and VWMRI of N=25 consecutive patients were included from September 2016-2017, resulting in 22 patients with 25 aneurysms, 9 with and 16 without AWE. Patient-specific CFD models of hemodynamics were created from DSA. Univariate and multivariate analyses were performed to investigate the association between AWE and conventional morphological and hemodynamic factors.

Results: AWE group had low wall shear stress (p<0.001) and sac-averaged velocity (p<0.001), larger size (p<0.001), and higher size ratio (p=0.0116) and non-spherity index (p<0.01). From multivariate analysis of both hemodynamic and morphological factors, only low wall shear stress was found to be independently associated with AWE.

Conclusion: The presence of AWE was associated conventional rupture-risk morphological and hemodynamic factors. However, only low wall shear stress was found to be an independent predictor of AWE. Our findings suggest the hypothesis that low WSS may play an important role in aneurysm wall degradation, and VWMRI may be augmented with CFD-based hemodynamic factors.