In vivo assessment of the impact of regional intracranial atherosclerotic lesions on brain arterial 3D hemodynamics

C. Wu*, S. Schnell, P. Vakil, A. R. Honarmand, S. A. Ansari, J. Carr, M. Markl, S. Prabhakaran

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

11 Scopus citations

Abstract

Background and Purpose: Intracranial atherosclerosis induces hemodynamic disturbance, which is not well-characterized, particularly in cerebral flow redistribution. We aimed to characterize the impact of regional stenotic lesions on intracranial hemodynamics by using 4D flow MR imaging. MATERIALS AND METHODS: 4D flow MR imaging was performed in 22 symptomatic patients (mean age, 68.4 < 14.2 years) with intracranial stenosis (ICA, n = 7; MCA, n = 9; basilar artery, n = 6) and 10 age-appropriate healthy volunteers (mean age, 60.7 < 8.1 years). 3D blood flow patterns were visualized by using time-integrated pathlines. Blood flow and peak velocity asymmetry indices were compared between patients and healthy volunteers in 4 prespecified arteries: ICAs, MCAs, and anterior/posterior cerebral arteries. RESULTS: 3D blood flow pathlines demonstrated flow redistribution across cerebral arteries in patients with unilateral intracranial stenosis. For patients with ICA stenosis compared with healthy volunteers, significantly lower flow and peak velocities were identified in the ipsilateral ICA (P =.001 and P =.001) and MCA (P <.001 and P =.001), but higher flow, in the ipsilateral PCA (P <.001). For patients with MCA stenosis, significantly lower flow and peak velocities were observed in the ipsilateral ICA (P =.009 and P =.045) and MCA (P <.001 and P =.005), but significantly higher flow was found in the ipsilateral posterior cerebral artery (P =.014) and anterior cerebral artery (P =.006). The asymmetry indices were not significantly different between patients with basilar artery stenosis and the healthy volunteers. CONCLUSIONS: Regional intracranial atherosclerotic lesions not only alter distal arterial flow but also significantly affect ipsilateral collateral arterial hemodynamics.

Original languageEnglish (US)
Pages (from-to)515-522
Number of pages8
JournalAmerican Journal of Neuroradiology
Volume38
Issue number3
DOIs
StatePublished - Mar 2017

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Clinical Neurology

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