Lyu Zonghan, Gudino Andres, Shenoy Navami, Dier Carlos, Sagues Elena, Jiang Jingfeng, Samaniego Edgar A
Michigan Technological University, Houghton, United States.
University of Iowa, Iowa City, United States.
Neuroradiology. 2025 Aug 18. doi: 10.1007/s00234-025-03730-x.
Evaluating intracranial aneurysm (IA) rupture risk is essential for guiding management. Although intrasaccular thrombosis (IST) is less common, it can contribute to aneurysm growth, mass effect, and rupture. Aneurysm wall enhancement (AWE) on high-resolution MRI (HR-MRI) offers valuable insight into IST and IA progression. Using radiomics, we extracted spatial information of the aneurysm wall to characterize AWE. This study aimed to explore correlations between radiomics-based AWE profiles and gross hemodynamic parameters, integrating imaging and flow dynamics to better understand IST.
Radiomic analysis was conducted on a cohort of 3T HR-MRI scans from IA with IST. Three-dimensional vascular reconstructions and CFD simulations were conducted to quantify hemodynamic parameters. Spearman's correlation was performed to correlate aneurysm morphology, AWE patterns, and aneurysmal hemodynamic characteristics.
A total of 37 thrombosed IAs were included in the analysis, comprising 22 fusiform (59.5%) and 15 saccular (40.5%) aneurysms. Six AWE RFs demonstrated strong correlations with aneurysm volume and surface area (ρ > 0.7 for both). Ten AWE RFs were highly correlated with flow vortex parameters (ρ > 0.7), and one showed a strong correlation with wall shear stress (WSS)-related metrics (ρ > 0.7). In the subset of saccular IAs, 20 AWE RFs were strongly associated with WSS-related metrics. In contrast, fusiform IAs showed stronger correlations between AWE RFs and vortex core characteristics. These findings suggest that elevated AWE is closely associated with regions of high oscillatory shear index and unstable flow vortices, indicating a potential link between wall enhancement and disturbed intra-aneurysmal hemodynamics. Conclusions Stagnant flow may promote degenerative remodeling of the aneurysm wall and IST. A combined spatiotemporal analysis of hemodynamic parameters and AWE patterns provide information about underlying biological processes of IAs, including the development of IST.
评估颅内动脉瘤（IA）破裂风险对于指导治疗至关重要。尽管瘤内血栓形成（IST）不太常见，但它可导致动脉瘤生长、占位效应和破裂。高分辨率磁共振成像（HR-MRI）上的动脉瘤壁强化（AWE）为IST和IA进展提供了有价值的见解。利用放射组学，我们提取了动脉瘤壁的空间信息以表征AWE。本研究旨在探讨基于放射组学的AWE特征与总体血流动力学参数之间的相关性，整合成像和血流动力学以更好地理解IST。
对一组伴有IST的IA的3T HR-MRI扫描进行放射组学分析。进行三维血管重建和计算流体动力学（CFD）模拟以量化血流动力学参数。采用Spearman相关性分析来关联动脉瘤形态、AWE模式和动脉瘤血流动力学特征。
分析共纳入37个血栓形成的IA，包括22个梭形动脉瘤（59.5%）和15个囊状动脉瘤（40.5%）。六个AWE放射组学特征与动脉瘤体积和表面积呈强相关性（两者ρ均>0.7）。十个AWE放射组学特征与血流涡旋参数高度相关（ρ>0.7），一个与壁面切应力（WSS）相关指标呈强相关性（ρ>0.7）。在囊状IA子集中，20个AWE放射组学特征与WSS相关指标密切相关。相比之下，梭形IA在AWE放射组学特征与涡核特征之间表现出更强的相关性。这些发现表明，AWE升高与高振荡剪切指数区域和不稳定的血流涡旋密切相关，提示壁强化与动脉瘤内血流动力学紊乱之间存在潜在联系。结论血流停滞可能促进动脉瘤壁的退行性重塑和IST。血流动力学参数和AWE模式的联合时空分析提供了有关IA潜在生物学过程的信息，包括IST的发展。
