Four-Dimensional Magnetic Resonance Imaging Assessment of Intracranial Aneurysms: A State-of-the-Art Review

Castle-Kirszbaum, M, Maingard, J, Lim, RP, Barras, CD, Kok, HK, Chandra, RV, Chong, W and Asadi, H 2020, Four-Dimensional Magnetic Resonance Imaging Assessment of Intracranial Aneurysms: A State-of-the-Art Review, Neurosurgery, vol. 87, no. 3, pp. 453-465, doi: 10.1093/neuros/nyaa021.

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Title Four-Dimensional Magnetic Resonance Imaging Assessment of Intracranial Aneurysms: A State-of-the-Art Review
Author(s) Castle-Kirszbaum, M
Maingard, J
Lim, RP
Barras, CD
Kok, HK
Chandra, RV
Chong, W
Asadi, HORCID iD for Asadi, H
Journal name Neurosurgery
Volume number 87
Issue number 3
Start page 453
End page 465
Total pages 13
Publisher Oxford University Press
Place of publication Oxford, Eng.
Publication date 2020-09
ISSN 0148-396X
Keyword(s) 4D
Summary Treatment of unruptured intracranial aneurysms can reduce the risk of subarachnoid hemorrhage and its associated morbidity and mortality. However, current methods to predict the risk of rupture and optimize treatment strategies for intracranial aneurysms are limited. Assessment of intra-aneurysmal flow using 4-dimensional magnetic resonance imaging (4D MRI) is a novel tool that could be used to guide therapy. A systematic search of the literature was performed to provide a state-of-the-art review on 4D MRI assessment of unruptured intracranial aneurysms. A total of 18 studies were available for review. Eccentric flow on 4D MRI is associated with a greater aspect ratio and peak wall shear stress (WSS). WSS, vorticity, and peak velocity are greater in saccular than fusiform aneurysms. Unstable aneurysms are associated with greater WSS, peak wall stress, and flow jet angle and may exhibit wall enhancement. In comparison to computational fluid dynamics (CFD), 4D MRI has a lower spatial resolution and reports lower WSS and velocity magnitudes, but these parameters equalize when spatial resolution is matched. 4D MRI demonstrates the intra-aneurysmal hemodynamic changes associated with flow diversion, including significantly decreased flow velocity. Thus, 4D MRI is a novel, noninvasive imaging tool used for the evaluation of hemodynamics within intracranial aneurysms. Hemodynamic indices derived from 4D MRI appear to correlate well with the simulated (CFD) values and may be used to measure the success of endovascular therapies and risk factors for aneurysm growth and rupture.
Language eng
DOI 10.1093/neuros/nyaa021
Indigenous content off
Field of Research 1103 Clinical Sciences
1109 Neurosciences
HERDC Research category C1 Refereed article in a scholarly journal
Copyright notice ©2020, Congress of Neurological Surgeons
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Document type: Journal Article
Collections: Faculty of Health
School of Medicine
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