Identification of Hostile Hemodynamics and Geometries of Cerebral Aneurysms: A Case-Control Study

B.J. Chung; F. Mut; C.M. Putman; F. Hamzei-Sichani; W. Brinjikji; D. Kallmes; C.M. Jimenez; J.R. Cebral

doi:10.3174/ajnr.A5764

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Fig 1.
Ratios of the mean values of the ruptured aneurysm group over mean values of the stable aneurysm group. Only hemodynamic (dark gray) and geometric (light gray) variables that were significantly different between these groups (P < .05 before adjusting for multiple testing) are included.
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Fig 2.
Ratios of mean values of the unstable aneurysm group over mean values of the stable aneurysm group. Only hemodynamic (dark gray) and geometric (light gray) variables that were significantly different (P < .05 before adjusting for multiple testing) or marginally significant (P < .1 before adjusting for multiple testing; marked with a plus sign) are included. ICI indicates inflow concentration index; BF, bottleneck factor; CR, convexity ratio.
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Fig 3.
Ratios of mean values of the ruptured aneurysm group over mean values of the unruptured aneurysm group. Only hemodynamic (dark gray) and geometric (light gray) variables that were significantly different between these groups (P < .05 before adjusting for multiple testing) are included.
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Fig 4.
Examples of stable (left), unstable (middle), and ruptured (right) aneurysms at a single location (posterior communicating artery). Visualizations show, from upper to lower: inflow jet, flow pattern, vortex core lines at 4 instants during the cardiac cycle, wall shear stress, and oscillatory shear index.

Tables

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Values of hemodynamic and geometric variables in stable, unstable, and ruptured aneurysms^{^a}

Variable	Unruptured			Ruptured
	Stable	Unstable
	Stable	Symptoms	Growing
WSSmin	0.8 ± 1.9	0.3 ± 0.5	1.0 ± 4.5	0.4 ± 1.3
WSSmax	223.7 ± 187.5	235.0 ± 101.8	253.7 ± 170.2	377.5 ± 948.8
WSSmean	21.4 ± 18.5	16.6 ± 13.8	22.0 ± 22.1	23.2 ± 28.9
WSSnorm	0.6 ± 0.3	0.4 ± 0.3	0.5 ± 0.3	0.4 ± 0.3
SCI	3.78 ± 4.76	8.52 ± 9.44	5.52 ± 4.53	6.23 ± 6.88
LSA	45.8 ± 33.6	62.9 ± 29.7	58.8 ± 30.9	51.6 ± 33.0
OSImax	0.259 ± 0.137	0.358 ± 0.089	0.303 ± 0.125	0.317 ± 0.114
OSImean	0.012 ± 0.011	0.014 ± 0.008	0.017 ± 0.016	0.017 ± 0.017
Q	0.746 ± 0.805	1.360 ± 1.368	1.081 ± 0.957	0.730 ± 0.807
ICI	0.716 ± 0.763	1.193 ± 1.309	1.088 ± 0.941	0.791 ± 0.764
Vmax	62.9 ± 31.8	70.8 ± 19.6	80.4 ± 50.0	88.8 ± 62.6
VE	9.7 ± 6.4	8.7 ± 5.7	10.1 ± 6.1	9.8 ± 8.1
SR	226.2 ± 176.1	155.0 ± 131.4	202.9 ± 221.2	231.5 ± 260.7
VO	307.7 ± 241.1	218.0 ± 183.7	278.9 ± 279.0	317.4 ± 344.4
CORELEN	1.753 ± 3.313	2.726 ± 1.827	2.504 ± 3.043	2.378 ± 2.593
PODENT	0.176 ± 0.125	0.227 ± 0.115	0.228 ± 0.155	0.207 ± 0.137
Asize	0.687 ± 0.524	1.109 ± 0.603	0.933 ± 0.550	0.770 ± 0.398
Nsize	0.482 ± 0.309	0.690 ± 0.461	0.577 ± 0.311	0.429 ± 0.172
SizeR	1.834 ± 1.395	2.440 ± 1.127	2.533 ± 1.487	2.492 ± 1.373
AR	0.879 ± 0.607	1.308 ± 0.828	1.200 ± 0.831	1.304 ± 0.691
VOR	0.894 ± 3.355	1.220 ± 1.310	1.460 ± 2.906	0.919 ± 1.559
EI	0.273 ± 0.036	0.268 ± 0.021	0.263 ± 0.026	0.273 ± 0.025
NSI	0.202 ± 0.051	0.229 ± 0.080	0.211 ± 0.041	0.246 ± 0.054
BF	1.167 ± 0.465	1.414 ± 0.478	1.377 ± 0.574	1.322 ± 0.441
BL	0.290 ± 0.161	0.431 ± 0.170	0.361 ± 0.144	0.355 ± 0.163
CR	0.762 ± 0.144	0.793 ± 0.083	0.816 ± 0.118	0.785 ± 0.100
CP	0.210 ± 0.161	0.069 ± 0.170	0.139 ± 0.144	0.145 ± 0.163
UI	0.238 ± 0.144	0.207 ± 0.083	0.184 ± 0.118	0.215 ± 0.100
GAA	16.339 ± 17.905	5.861 ± 4.444	7.893 ± 8.034	12.763 ± 13.717

Note:—Q indicates aneurysm flow rate; ICI, inflow concentration index; VE, mean aneurysm velocity; SR, mean aneurysm shear rate; VO, mean aneurysm velocity; PODENT, POD entropy, flow instability; POD, proper orthogonal decomposition; Nsize, neck maximum size; EI, ellipticity index; BF, bottleneck factor; CR, convexity ratio; UI, undulation index; WSSnorm, normalized wall shear stress.
↵a Values are given as mean ± SD.