Determining Significant Morphological and Hemodynamic Parameters to Assess the Rupture Risk of Cerebral Aneurysms

Risk factors predicting a higher grade of subarachnoid haemorrhage in small ruptured intracranial aneurysm (< 5 mm)

“…Female gender, history of SAH, and cigarette smoking have all been identified as independent risk factors for aneurysm rupture in previous studies [34][35][36]. In our study, previous SAH was significantly associated with a high Hunt and Hess scale grade, and smoking was significantly associated with a high FG.…”

Assessing the Risk of Intracranial Aneurysm Rupture Using Morphological and Hemodynamic Biomarkers Evaluated from Magnetic Resonance Fluid Dynamics and Computational Fluid Dynamics

“…However, several studies have reported WSS in the aneurysm as a significant parameter in the rupture risk assessment. [23][24][25][26] In addition, ICI was unable to show a significant effect on the aneurysm rupture risk in the present study in contrast to the initial findings reported by Cebral et al 20 With respect to another two hemodynamic biomarkers, although we attempted the analysis of EL 21 and PLc, 22 confounding results were observed possibly due to the distinctive ways of approximation of static pressure variable by the fluid dynamic analysis software. Those results are not presented in this study as further scrutiny is warranted regarding the biomarker definitions and way of analysis.…”

“…10 Shearing velocity is calculated by dividing velocity along the wall by distance from wall to the velocity measuring point. WSS related parameters evaluated in this study were time averaged wall shear stress (TAWSS), [23][24][25][26] oscillatory shear index (OSI) 27 and relative residence time (RRT). 28 TAWSS, OSI and RRT were further analyzed to obtain spatial average, spatial maximum and spatial minimum values.…”

“…16 Several recent studies have investigated morphological and hemodynamic parameters to assess the rupture risk of intracranial aneurysms and have found significant results with respect to aspect ratio, 17 size ratio, 18 presence of blebs, 5 nonsphericity index (NSI), 19 inflow concentration index, 20 energy loss, 21 pressure loss coefficient 22 and wall shear stress derivatives. [23][24][25][26][27][28] However, all of these studies are based on CFD analysis and none of these studies had used patient specific inflow-outflow boundary conditions for the analysis which is a major limitation. In addition, to our knowledge, no rigorous intracranial aneurysm rupture risk assessment study has been reported that utilizes MRFD analysis with representative larger samples rather than case reports.…”

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“…We analyzed the statistical significance of all parameters from CFD simulations and morphological parameters through ANOVA statistic tests, where we selected the variables shown in Table 1, satisfying the tolerance of P-value, and besides, we considered the smallest quantity of them. In Table 1, all quantities had higher value of the mean in the ruptured than in the unruptured group, except TAWSS, in accordance with the results obtained by Xiang et al [34] and [35]. We also analyzed other morphological parameters such as Non-sphericity index (NSI), Aneurysm Inclination Angle (AIA), volume and area of the aneurysm being less statistically significant than AR and BNF, which is in good agreement with previous works [36].…”