Phase-contrast MRI versus numerical simulation to quantify hemodynamical changes in cerebral aneurysms after flow diverter treatment

PLoS One. 2018 Jan 5;13(1):e0190696. doi: 10.1371/journal.pone.0190696. eCollection 2018.

Abstract

Cerebral aneurysms are a major risk factor for intracranial bleeding with devastating consequences for the patient. One recently established treatment is the implantation of flow-diverters (FD). Methods to predict their treatment success before or directly after implantation are not well investigated yet. The aim of this work was to quantitatively study hemodynamic parameters in patient-specific models of treated cerebral aneurysms and its correlation with the clinical outcome. Hemodynamics were evaluated using both computational fluid dynamics (CFD) and phase contrast (PC) MRI. CFD simulations and in vitro MRI measurements were done under similar flow conditions and results of both methods were comparatively analyzed. For preoperative and postoperative distribution of hemodynamic parameters, CFD simulations and PC-MRI velocity measurements showed similar results. In both cases where no occlusion of the aneurysm was observed after six months, a flow reduction of about 30-50% was found, while in the clinically successful case with complete occlusion of the aneurysm after 6 months, the flow reduction was about 80%. No vortex was observed in any of the three models after treatment. The results are in agreement with recent studies suggesting that CFD simulations can predict post-treatment aneurysm flow alteration already before implantation of a FD and PC-MRI could validate the predicted hemodynamic changes right after implantation of a FD.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Blood Flow Velocity
  • Cerebrovascular Circulation* / physiology
  • Female
  • Humans
  • Intracranial Aneurysm / diagnostic imaging
  • Intracranial Aneurysm / physiopathology*
  • Intracranial Aneurysm / surgery*
  • Magnetic Resonance Imaging* / instrumentation
  • Magnetic Resonance Imaging* / methods
  • Male
  • Middle Aged
  • Models, Anatomic
  • Models, Neurological*
  • Patient-Specific Modeling*
  • Phantoms, Imaging
  • Printing, Three-Dimensional
  • Silicones
  • Treatment Outcome

Substances

  • Silicones

Grants and funding

This work was supported by Russian Science Foundation (Project 16-15-10327). This work was supported by the German Research Foundation (DFG) and the Technical University of Munich (TUM) in the framework of the Open Access Publishing Program. We thank Acandis GmbH & Co. KG for providing the DERIVO Embolisation Device and silicone models of aneurysms for experimental studies. The reported study was supported by the Supercomputing Center of Lomonosov Moscow State University. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.