Hemodynamics of Cerebral Aneurysms: Connecting Medical Imaging and Biomechanical Analysis

Rayz, Vitaliy L.; Cohen-Gadol, Aaron

doi:10.1146/annurev-bioeng-092419-061429

Cited by 32 publications

(28 citation statements)

References 163 publications

(223 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…[ 5 , 22 ] Given that each modality has its strong and weak points, combining data obtained from different modalities has been proposed in order to ensure the reliability of the results and to help the realization of hemodynamic analysis in clinical decision-making. [ 28 ] In this work, we conducted a multi-modality study based on a patient-specific intracranial aneurysm. The velocity field, vorticity, and WSS magnitude were compared between Tomo-PIV, Stereo-PIV, in vivo 4D Flow MRI, and CFD.…”

Section: Discussionmentioning

confidence: 99%

“…It is estimated that between 1 and 5% of the general population are affected by this condition and that 20-30% of the affected population have multiple aneurysms. [ 2 , 37 , 28 ] The rupture of an intracranial aneurysm can cause subarachnoid haemorrhage (SAH), which has a high mortality rate of almost 50%. [ 1 ] On the other hand, the clinical treatment of an unruptured aneurysm also comes with risks.…”

Section: Introductionmentioning

confidence: 99%

“…Integrating data (namely in vivo , in vitro , and in silico datasets) is one of the recommended approaches for validating numerical results and providing comprehensive hemodynamic assessments. [ 28 ] To date, only one multi-modality study has performed a comparison of WSS obtained by in vivo 4D Flow MRI, CFD, and in vitro STB techniques under pulsatile condition. [ 4 ] However, the high cycle-to-cycle flow variations under pulsatile flow can cause large differences in flow measurements between different modalities, [ 22 ] which will amplify the variations in velocity-derived parameters.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Hemodynamic Study of a Patient-Specific Intracranial Aneurysm: Comparative Assessment of Tomographic PIV, Stereoscopic PIV, In Vivo MRI and Computational Fluid Dynamics

Gürzing

Schinkel

et al. 2021

Cardiovasc Eng Tech

View full text Add to dashboard Cite

Introduction Wall shear stress (WSS) is associated with the growth and rupture of an intracranial aneurysm. To reveal their underlying connections, many image-based computational fluid dynamics (CFD) studies have been conducted. However, the methodological validations using both in vivo medical imaging and in vitro optical flow measurements were rarely accompanied in such studies. Methods In the present study, we performed a comparative assessment on the hemodynamics of a patient-specific intracranial saccular aneurysm using in vivo 4D Flow MRI, in silico CFD, in vitro stereoscopic and tomographic particle imaging velocimetry (Stereo-PIV and Tomo-PIV) techniques. PIV experiments and CFD were conducted under steady state corresponding to the peak systole of 4D Flow MRI. Results The results showed that all modalities provided similar flow features and overall surface distribution of WSS. However, a large variation in the absolute WSS values was found. 4D Flow MRI estimated a 2- to 4-fold lower peak WSS (3.99 Pa) and a 1.6- to 2-fold lower mean WSS (0.94 Pa) than Tomo-PIV, Stereo-PIV, and CFD. Bland-Altman plots of WSS showed that the differences between PIV-/CFD-based WSS and 4D Flow MRI-based WSS increase with higher WSS magnitude. Such proportional trend was absent in the Bland-Altman comparison of velocity where the resolutions of PIV and CFD datasets were matched to 4D Flow MRI. We also found that because of superior resolution in the out-of-plane direction, WSS estimation by Tomo-PIV was higher than Stereo-PIV. Conclusions Our results indicated that the differences in spatial resolution could be the main contributor to the discrepancies between each modality. The findings of this study suggest that with current techniques, care should be taken when using absolute WSS values to perform a quantitative risk analysis of aneurysm rupture.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Hemodynamic Study of a Patient-Specific Intracranial Aneurysm: Comparative Assessment of Tomographic PIV, Stereoscopic PIV, In Vivo MRI and Computational Fluid Dynamics

Gürzing

Schinkel

et al. 2021

Cardiovasc Eng Tech

View full text Add to dashboard Cite

show abstract

“…Fifty to eighty percent of IAs remain, however, asymptomatic and do not rupture [ 2 ]. The etiology of IA formation, growth and rupture remains unclear, although hemodynamic factors are thought to play an important role [ 3 ].…”

Section: Introductionmentioning

confidence: 99%

The Role of Hemodynamics through the Circle of Willis in the Development of Intracranial Aneurysm: A Systematic Review of Numerical Models

Shen

Molenberg

Bokkers

et al. 2022

JPM

View full text Add to dashboard Cite

Background: The role of regional hemodynamics in the intracranial aneurysmal formation, growth, and rupture has been widely discussed based on numerical models over the past decades. Variation of the circle of Willis (CoW), which results in hemodynamic changes, is associated with the aneurysmal formation and rupture. However, such correlation has not been further clarified yet. The aim of this systematic review is to investigate whether simulated hemodynamic indices of the CoW are relevant to the formation, growth, or rupture of intracranial aneurysm. Methods: We conducted a review of MEDLINE, Web of Science, and EMBASE for studies on the correlation between hemodynamics indices of the CoW derived from numerical models and intracranial aneurysm up to December 2020 in compliance with PRISMA guidelines. Results: Three case reports out of 1046 publications met our inclusion and exclusion criteria, reporting 13 aneurysms in six patients. Eleven aneurysms were unruptured, and the state of the other two aneurysms was unknown. Wall shear stress, oscillatory shear index, von-Mises tension, flow velocity, and flow rate were reported as hemodynamic indices. Due to limited cases and significant heterogeneity between study settings, meta-analysis could not be performed. Conclusion: Numerical models can provide comprehensive information on the cerebral blood flow as well as local flow characteristics in the intracranial aneurysm. Based on only three case reports, no firm conclusion can be drawn regarding the correlation between hemodynamic parameters in the CoW derived from numerical models and aneurysmal formation or rupture. Due to the inherent nature of numerical models, more sensitive analysis and rigorous validations are required to determine its measurement error and thus extend their application into clinical practice for personalized management. Prospero registration number: CRD42021125169.

show abstract

“…Detailed study of hemodynamics in stenosis will be useful in the diagnosis and treatment of vascular diseases [6]. Clinically analyzing the hemodynamics will not yield the detailed investigation using current diagnostic imaging options such as angiography, CTA, MRA or duplex scanning [7]. The detailed information about the hemodynamics in diseased vessels can be obtained from the numerical simulations, and such simulations will help in obtaining a better insight in predicting the hemodynamics.…”

Section: Introductionmentioning

confidence: 99%

Fluid Structure Interaction Study of Stenosed Carotid Artery Considering the Effects of Blood Pressure and Altered Gravity

Khader¹,

Kumar²,

Pai³

2021

Finite Element Methods and Their Applications

View full text Add to dashboard Cite

Atherosclerosis is a very common cardiovascular disease (CVD) causing increased morbidity. Atherosclerosis is a disease that involves several factors and usually affects the wall of the arterial bifurcations. Advanced Computational Fluid Dynamics (CFD) techniques has the potential to shed more light in understanding of the causes of atherosclerosis and perhaps in its early diagnosis. Fluid Structure Interaction (FSI) study was carried out on two different three dimensional patient specific cases (a) Normal carotid bifurcation and (b) Stenosed carotid bifurcation. Physiological conditions were considered to evaluate hemodynamic parameters and understand the origin and progression of atherosclerosis in the carotid artery bifurcation, first for the normal and then with hypertension disease. Commercial software ANSYS and ANSYS CFX (version 19.0) was used to perform a two-way FSI using a fully implicit second-order backward Euler differencing scheme. Arterial response was calculated by employing an Arbitrary Lagrangian-Eulerian (ALE) formulation and using the temporal blood response. The carotid artery bifurcation caused a velocity reduction and backflow was observed causing a reduction in the shear stress. A low shear stress resulted due to an oscillatory behavior at the start point of the internal carotid artery near the carotid sinus. Shear stresses are obtained by using anatomically realistic 3D geometry and representative physiological conditions. Results of this study agree with those in the literature showing that the regions with low wall shear stress. Geometry and flow conditions greatly affected the hemodynamics of the carotid artery. Furthermore, regions of relatively low wall shear stress were observed post stenosis, which is a known cause of plaque development and progression. Under altered gravity conditions the same artery was studied to determine the flow conditions and predict the progression of plague.

show abstract

Hemodynamics of Cerebral Aneurysms: Connecting Medical Imaging and Biomechanical Analysis

Cited by 32 publications

References 163 publications

Hemodynamic Study of a Patient-Specific Intracranial Aneurysm: Comparative Assessment of Tomographic PIV, Stereoscopic PIV, In Vivo MRI and Computational Fluid Dynamics

Hemodynamic Study of a Patient-Specific Intracranial Aneurysm: Comparative Assessment of Tomographic PIV, Stereoscopic PIV, In Vivo MRI and Computational Fluid Dynamics

The Role of Hemodynamics through the Circle of Willis in the Development of Intracranial Aneurysm: A Systematic Review of Numerical Models

Fluid Structure Interaction Study of Stenosed Carotid Artery Considering the Effects of Blood Pressure and Altered Gravity

Contact Info

Product

Resources

About