4d血流mri显示的壁面剪切应力降低与未破裂颅内动脉瘤壁面不稳定有关

IF 3.2 3区医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

European Journal of Radiology Pub Date : 2025-05-27 DOI:10.1016/j.ejrad.2025.112200

Qichang Fu , Xinmei Ma , Linghao Li , Wanjun Xia , Shanshan Xie , Jumatay Biekan , Mengzhu Wang , Jianfeng Bao , Junying Cheng , Yong Zhang , Sheng Guan , Jingliang Cheng

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引用次数: 0

摘要

背景与目的未破裂颅内动脉瘤（UIAs）壁不稳定与动脉瘤生长或破裂有关。4d血流mri的壁剪切应力（WSS）可以反映动脉瘤壁的血流动力学异常。血管壁MRI （VWI）的动脉瘤壁增强（AWE）和动态增强MRI （DCE-MRI）的体积传递常数（Ktrans）可以指示不稳定动脉瘤壁的炎症和通透性变化。我们假设UIAs的WSS不仅与AWE和Ktrans有关，而且与动脉瘤的ELAPSS或分期评分得出的生长或破裂风险有关。材料与方法对2018年1月至2023年10月在我院接受3.0 T VWI、DCE-MRI、4D-flow-MRI检查的uas患者进行横断面回顾性分析。分别通过VWI、DCE-MRI和4D-flow MRI获得AWE、Ktrans和WSS。采用AWE模式（AWEP）和壁增强指数（WEI）评价AWE。根据ELAPSS评分和分期评分分别预测3年和5年动脉瘤生长风险和5年破裂风险。使用Spearman相关系数或逻辑回归评估参数之间的相关性。结果78例（女性53例）96个动脉瘤纳入研究。WSS在AWEP亚组间存在差异(p <；0.001)。WSS与AWEP、WEI、Ktrans呈负相关(rs = - 0.35、rs = - 0.44、rs = - 0.25；p & lt;0.001)。多元logistic回归显示WSS降低与AWE发生率升高相关（OR: 0.65, 95% CI: 0.48 ~ 0.87）。WSS与3年、5年生长风险和5年破裂风险呈负相关(rs = - 0.47, rs = - 0.44, rs = - 0.50；p & lt;0.001)。结论动脉瘤4d血流mri wss与AWEP、WEI、Ktrans、生长及破裂风险呈负相关。4d血流mri上WSS的降低可能为评估动脉瘤壁不稳定性提供有价值的信息。

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Decreased wall shear stress on 4D-flow-MRI is associated with wall instability of unruptured intracranial aneurysm

Background and purpose

The wall instability of unruptured intracranial aneurysms (UIAs) is associated with aneurysm growth or rupture. The wall shear stress (WSS) of 4D-flow-MRI can indicate hemodynamic abnormalities on the aneurysm wall. Aneurysm wall enhancement (AWE) of vessel wall MRI (VWI) and volume transfer constant (K^trans) of dynamic contrast-enhanced MRI (DCE-MRI) can indicate inflammation and permeability changes of the unstable aneurysm wall. We hypothesize that the WSS of UIAs is not only associated with AWE and K^trans but also with the risk of growth or rupture derived from the ELAPSS or PHASES scores of the aneurysm.

Materials and methods

A cross-sectional retrospective analysis was performed on patients with UIAs who underwent 3.0 T VWI, DCE-MRI, and 4D-flow-MRI in our hospital from January 2018 to October 2023. AWE, K^trans, and WSS were obtained by VWI, DCE-MRI, and 4D-flow MRI, respectively. AWE pattern (AWEP) and wall enhancement index (WEI) were used to evaluate AWE. 3- and 5-year aneurysm growth risk and 5-year rupture risk were predicted based on ELAPSS and PHASES scores, respectively. Correlations between parameters were assessed using Spearman’s correlation coefficient or logistic regression.

Results

Ninety-six aneurysms in 78 patients (53 women) were included in the study. WSS differed across AWEP subgroups (p < 0.001). WSS was negatively correlated with AWEP, WEI, and K^trans (rs = −0.35, rs = −0.44, and rs = −0.25; p < 0.001). Multiple logistic regression indicated that decreased WSS was associated with higher odds of AWE (OR: 0.65, 95 % CI: 0.48–0.87). WSS was negatively correlated with the 3- and 5-year growth risk and the 5-year risk of rupture (rs = −0.47, rs = −0.44, and rs = −0.50; p < 0.001).

Conclusion

WSS on 4D-flow-MRI of aneurysms is inversely associated with AWEP, WEI, and K^trans and growth and rupture risk. The decrease in WSS on 4D-flow-MRI may provide valuable information for assessing aneurysm wall instability.

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来源期刊

European Journal of Radiology 医学-核医学

CiteScore

6.70

自引率

3.00%

发文量

398

审稿时长

42 days

期刊介绍： European Journal of Radiology is an international journal which aims to communicate to its readers, state-of-the-art information on imaging developments in the form of high quality original research articles and timely reviews on current developments in the field. Its audience includes clinicians at all levels of training including radiology trainees, newly qualified imaging specialists and the experienced radiologist. Its aim is to inform efficient, appropriate and evidence-based imaging practice to the benefit of patients worldwide.