Tang Yudi, Wei Haining, Zhang Zihao, Fu Mingzhu, Feng Junqiang, Li Zhixin, Liu Xinke, Wu Yue, Zhang Jinyuan, You Wei, Xue Rong, Zhuo Yan, Jiang Yuhua, Li Youxiang, Li Rui, Liu Peng
Department of Neurosurgery, Beijing Neurosurgical Institute and Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
Center for Biomedical Imaging Research, Department of Biomedical Engineering, Medical School, Tsinghua University, Beijing, China.
Heliyon. 2024 Apr 23;10(9):e30006. doi: 10.1016/j.heliyon.2024.e30006. eCollection 2024 May 15.
Wall shear stress (WSS) has been proved to be related to the formation, development and rupture of intracranial aneurysms. Aneurysm wall enhancement (AWE) on magnetic resonance imaging (MRI) can be caused by inflammation and have confirmed its relationship with low WSS. High WSS can also result in inflammation but the research of its correlation with AWE is lack because of the focus on large aneurysms limited by 3T MRI in most previous studies.This study aimed to assess the potential association between high or low WSS and AWE in different aneuryms. Especially the relationship between high WSS and AWE in small aneurysm.
Forty-three unruptured intracranial aneurysms in 42 patients were prospectively included for analysis. 7.0 T MRI was used for imaging. Aneurysm size was measured on three-dimensional time-of-flight (TOF) images. Aneurysm-to-pituitary stalk contrast ratio (CRstalk) was calculated on post-contrast black-blood T1-weighted fast spin echo sequence images. Hemodynamics were assessed by four-dimensional flow MRI.
The small aneurysms group had more positive WSS-CRstalk correlation coefficient distribution (dome: 78.6 %, p = 0.009; body: 50.0 %, p = 0.025), and large group had more negative coefficient distribution (dome: 44.8 %, p = 0.001; body: 69.0 %, p = 0.002). Aneurysm size was positively correlated with the significant OSI-CRstalk correlation coefficient at the dome (p = 0.012) and body (p = 0.010) but negatively correlated with the significant WSS-CRstalk correlation coefficient at the dome (p < 0.001) and body (p = 0.017).
AWE can be mediated by both high and low WSS, and translate from high WSS- to low WSS-mediated pathways as size increase. Additionally, AWE may serve as an indicator of the stage of aneurysm development via different correlations with hemodynamic factors.
壁面剪应力（WSS）已被证明与颅内动脉瘤的形成、发展和破裂有关。磁共振成像（MRI）上的动脉瘤壁强化（AWE）可由炎症引起，并已证实其与低WSS有关。高WSS也可导致炎症，但由于大多数先前研究受3T MRI限制主要关注大型动脉瘤，其与AWE相关性的研究较少。本研究旨在评估不同动脉瘤中高或低WSS与AWE之间的潜在关联。特别是小动脉瘤中高WSS与AWE之间的关系。
前瞻性纳入42例患者的43个未破裂颅内动脉瘤进行分析。使用7.0T MRI进行成像。在三维时间飞跃（TOF）图像上测量动脉瘤大小。在对比剂增强黑血T1加权快速自旋回波序列图像上计算动脉瘤与垂体柄对比率（CRstalk）。通过四维血流MRI评估血流动力学。
小动脉瘤组WSS-CRstalk相关系数分布为正的比例更高（瘤顶：78.6%，p = 0.009；瘤体：50.0%，p = 0.025），而大动脉瘤组负相关系数分布比例更高（瘤顶：44.8%，p = 0.001；瘤体：69.0%，p = 0.002）。动脉瘤大小与瘤顶（p = 0.012）和瘤体（p = 0.010）处显著的OSI-CRstalk相关系数呈正相关，但与瘤顶（p < 0.001）和瘤体（p = 0.017）处显著的WSS-CRstalk相关系数呈负相关。
AWE可由高和低WSS介导，并随着动脉瘤大小增加从高WSS介导途径转变为低WSS介导途径。此外，AWE可能通过与血流动力学因素的不同相关性作为动脉瘤发展阶段的一个指标。
