Intracranial Aneurysm Correlations: Vessel Wall Imaging, Hemodynamics, and Histology

Unruptured intracranial aneurysms (UIA) are evaluated with angiography, or non-invasive (MRI, CT). Current techniques present limitations on the resolution with which the vessel wall characteristics can be measured, presenting a major challenge to differential diagnostic of cerebral vasculopathies. A new combined approach is presented that incorporates patient-specific image-based CFD models with Vessel-Wall MRI (VWMRI). Comparisons of the VWMRI measurements, evaluated for the presence of wall enhancement and thin-walled regions, against CFD metrics such as wall shear stress (WSS), and oscillatory shear index (OSI) are used to understand how the new imaging technique developed can predict the influence of hemodynamics on the deterioration of the aneurysmal wall, leading to rupture. Additionally, histology of each resected aneurysm is evaluated for inflammatory features to independently validate the VWMRI and CFD. The results elicit the complexity associated with unstable wall change evaluation in UIAs and potential use for combined modalities (VWMRI-CFD) to support clinical monitoring and intervention decisions.