TY - JOUR
T1 - In vivo assessment of the impact of regional intracranial atherosclerotic lesions on brain arterial 3D hemodynamics
AU - Wu, C.
AU - Schnell, S.
AU - Vakil, P.
AU - Honarmand, A. R.
AU - Ansari, S. A.
AU - Carr, J.
AU - Markl, M.
AU - Prabhakaran, S.
PY - 2017/3
Y1 - 2017/3
N2 - 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.
AB - 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.
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U2 - 10.3174/ajnr.A5051
DO - 10.3174/ajnr.A5051
M3 - Article
C2 - 28057635
AN - SCOPUS:85015793879
SN - 0195-6108
VL - 38
SP - 515
EP - 522
JO - American Journal of Neuroradiology
JF - American Journal of Neuroradiology
IS - 3
ER -