AUTHOR=Zhu Yajun , Zou Rong , Sun Xiaochuan , Lei Xingwei , Xiang Jianping , Guo Zongduo , Su Hai 

TITLE=Assessing the risk of intracranial aneurysm rupture using computational fluid dynamics: a pilot study

JOURNAL=Frontiers in Neurology

VOLUME=14

YEAR=2023

URL=https://www.frontiersin.org/journals/neurology/articles/10.3389/fneur.2023.1277278

DOI=10.3389/fneur.2023.1277278

ISSN=1664-2295

ABSTRACT=<sec id="sec1"><title>Objective</title><p>This study compared 2 representative cases with ruptured aneurysms to explore the role of hemodynamic and morphological parameters in evaluating the rupture risk of intracranial aneurysms (IAs).</p></sec><sec id="sec2"><title>Methods</title><p>CTA and 3-dimensional rotational angiography (3DRA) of 3 IAs in 2 patients were retrospectively analyzed in this study. Hemodynamics and morphological parameters were compared between a ruptured IA and an unruptured IA in case1, and between before and after aneurysm rupture in case 2.</p></sec><sec id="sec3"><title>Results</title><p>In case 1, the ruptured aneurysm had larger morphological parameters including size ratio (SR), aspect ratio (AR), aneurysm vessel angle (<italic>θ</italic><sub>F</sub>), Aneurysm inclination angle (<italic>θ</italic><sub>A</sub>), Undulation index (UI), Ellipticity index (EI), and Non-sphericity Index (NSI) than the unruptured aneurysm. And oscillatory shear index (OSI) is also larger. Higher rupture resemblance score (RRS) was shown in the ruptured aneurysm. In case 2, the aneurysm had one daughter sac after 2 years. Partial morphological and hemodynamic parameters including SR, AR, <italic>θ</italic><sub>F</sub>, <italic>θ</italic><sub>A</sub>, UI, EI, NSI, OSI, and relative residence time (RRT) increased, and normalized wall shear stress (NWSS) was significantly reduced. RRS increased during this period.</p></sec><sec id="sec4"><title>Conclusion</title><p>SR and OSI may have predictive values for the risk of intracranial aneurysm rupture. It is possible that WSS Changes before and after IA rupture, yet the influence of high or low WSS on growth and rupture of IA remains unclear. RRS is promising to be used in the clinical assessment of the rupture risk of IAs and to guide the formulation of treatment plans.</p></sec>