Article Sidebar

PDF
Date Published: 16/02/2023
Online Published: 16/02/2023
Abstract Views: 103
Views PDF: 52
DOI: https://doi.org/10.55046/vjrnm.48.753.2022
Issue
No. 02 (2022): English
Section
Scientific research
How to Cite
Nguyen, V. H., Vu, D. L., Tran, A. T., Le, H. K., Nguyen, Q. A., Nguyen, T. T., Nguyen, H. A., Nguyen, T. T. T., Tran, T. C., Tu, D. N., Le, H. K., Nguyen, T. H., Vu, T. T., & Pham, M. T. (2023). CHARACTERIZATION OF CEREBRAL ANEURYSMS FOR ASSESSING RISK OF RUPTURE BY USING ANEURYMS FLOW IN DSA. Vietnamese Journal of Radiology and Nuclear Medicine, 02, 44-52. https://doi.org/10.55046/vjrnm.48.753.2022

CHARACTERIZATION OF CEREBRAL ANEURYSMS FOR ASSESSING RISK OF RUPTURE BY USING ANEURYMS FLOW IN DSA

Van Hoang Nguyen1,, Vu Dang Luu2, Tran Anh Tuan2, Le Hoang Kien3, Dr Nguyen Quang Anh2, Dr Nguyen Tat Thien3, Nguyen Huu An3, Nguyễn Thị Thu Trang3, Tran Cuong3, Tư Duc Ngoc3, Lê Hoàng Khỏe3, Nguyen Thi Hao2, Vu Thi Thanh4, Professor Pham Minh Thong2
1 
2 Department of Diagnostic Imaging – Hanoi Medical University
3 Radiology Center - Bach Mai Hospital
4 Radiology Center – Bach Mai Hospital

Main Article Content

Abstract

Calcualting intra-aneurysm flow uses the optical flow with computational fluid dynamics simulation on the numerical analysis. This is a new method to better understand intravascular flow and aneurysm flow as well as factors related to the inflow vortex, and the inflow jet which increase the rupture risk on patients with aneurysm. The risk was provenly related to process of formation and development of the aneurysm besides factors mentioned in previous meta-analysis studies, such as female, aneurysm size, location like in the anterior communication artery or posterior arteries, smoking, hypertension, and aneurysm shape, ...


Objectives and subjects: A prospective study was conducted between July 2021 and July 2022. There were total 127 patients with aneurysm who took DSA – AneurysnsFlow and received treatment at Bach Mai hospital.


Results: In 127 patients with 170 aneurysms, there was 139 aneurysms in different location which were calculated their flow by AneurysmsFlow software in DSA at Bach Mai hospital. The  flow model affected mostly on the aneurysm wall, the most frequently seen was in the base (64.8%), or body (29.1%). Only 15% of aneurysm showed that the flow affected to aneurysm neck. According to the simple Cerebral classification based on inflow and the formation of the vortex as well as the consistence of the vortex, the flow group I (57.6%) is the most prevalent, next is the group IV (19.4%), the group II (12.2%), and the last one is the group III (10.8%). Simple consistent aneurysm models, large effect region, and large flow size were usually seen at unrupture aneurysms. Conversely, rupture aneurysms were likely to have vortex model, small effect area, and small flow size.


Conclusion: Flow calculation on DSA – Aneurysms Flow help to understand better the dynamic of flow in the mother artery and aneurysm which help to consider early treatment in high-risk ruptured aneurysm as well are thoroughly understand the dynamic inside the ruptured aneurysm to have a right treatment plan.

Article Details

Keywords

: intravascular flow, cerebral aneurysm, DSA – Aneurysms

References

1. Osborn AG. Diagnostic Cerebral Angiography. Lippincott Williams & Wilkins; 1999.
2. Vega C, Kwoon JV, Lavine SD. Intracranial Aneurysms: Current Evidence and Clinical Practice. AFP. 2002;66(4):601.
3. Johnston SC, Higashida RT, Barrow DL, et al. Recommendations for the endovascular treatment of intracranial aneurysms: a statement for healthcare professionals from the Committee on Cerebrovascular Imaging of the American Heart Association Council on Cardiovascular Radiology. Stroke. 2002;33(10):2536-2544. doi:10.1161/01. str.0000034708.66191.7d
4. Bonnefous O, Pereira VM, Ouared R, et al. Quantification of arterial flow using digital subtraction angiography. Med Phys. 2012;39(10):6264-6275. doi:10.1118/1.4754299
5. Pereira VM, Ouared R, Brina O, et al. Quantification of internal carotid artery flow with digital subtraction angiography: validation of an optical flow approach with Doppler ultrasound. AJNR Am J Neuroradiol. 2014;35(1):156-163. doi:10.3174/ajnr.A3662
6. Brina O, Ouared R, Bonnefous O, et al. Intra-Aneurysmal Flow Patterns: Illustrative Comparison among Digital Subtraction Angiography, Optical Flow, and Computational Fluid Dynamics. AJNR Am J Neuroradiol. 2014;35(12):2348-2353. doi:10.3174/ajnr.A4063
7. Killer-Oberpfalzer M, Kocer N, Griessenauer CJ, et al. European Multicenter Study for the Evaluation of a DualLayer Flow-Diverting Stent for Treatment of Wide-Neck Intracranial Aneurysms: The European Flow-Redirection Intraluminal Device Study. AJNR Am J Neuroradiol. 2018;39(5):841-847. doi:10.3174/ajnr.A5592
8. Vu Dang Luu. Clinical features and imaging characteristics of computed tomography and DSA of ruptured cerebral aneurysm. Evaluation of the effectiveness of embolization for treatment of the ruptured cerebral aneurysm. Thesis Doctor of Medicine, Hanoi Medical University. 2012.
9. Cebral JR, Castro MA, Burgess JE, Pergolizzi RS, Sheridan MJ, Putman CM. Characterization of cerebral aneurysms for assessing risk of rupture by using patient-specific computational hemodynamics models. AJNR Am J Neuroradiol. 2005;26(10):2550-2559.