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Original research
Non-contrast enhanced silent MR angiography to evaluate hemodynamics and morphology of unruptured intracranial aneurysms: a comparative computational fluid dynamics study
  1. Yuzhao Lu1,
  2. Xiaochang Leng2,
  3. Rong Zou2,
  4. Qi Chen2,
  5. Wenqiang Li3,
  6. Xiaobing Zhou1,
  7. Song Tan1,
  8. Xiaofei Huang1,
  9. Cong Ding1,
  10. Feixiang Gong1,
  11. Jianping Xiang2,
  12. Yang Wang4
  1. 1 Department of Neurosurgery, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
  2. 2 ArteryFlow Technology Co Ltd, Hangzhou, Zhejiang, China
  3. 3 Department of Neurosurgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
  4. 4 Department of Neurosurgery, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China
  1. Correspondence to Dr Yang Wang; wangyang6877{at}; Dr Jianping Xiang; jianping.xiang{at}


Background Silent MR angiography (silent MRA) is a new generation of non-contrast enhanced angiography with outstanding advantages in visualizing cerebrovascular lesions and the follow-up after endovascular treatment for intracranial aneurysms (IAs). This study aims to investigate the reliability of silent MRA-based three-dimensional (3D) geometric description and hemodynamic calculation of IAs.

Methods 19 patients with 23 unruptured IAs, who underwent both silent MRA and 3D rotational angiography (3DRA), were included in this study. Computational fluid dynamics simulations were performed on all patient-specific 3D reconstruction images to compare the morphology and hemodynamics of the two different imaging models for IAs.

Results Silent MRA models had smaller maximum and perpendicular height (mm), aneurysmal surface area (mm2), and aneurysmal volume (mm3) than 3DRA (p<0.05); the differences of the above parameters between the two models were 9.0±6.2%, 7.7±7.4%, 15.9±13.0%, and 21.4±17.5%, respectively. However, correlation analysis of morphological parameters in various dimensions and model comparison showed good overall consistency in geometrical characteristics between the two models. Moderate coherence was observed between models in time-averaged wall shear stress of aneurysm and parent vessel (TAWSS, PAWSS), aneurysm velocity (AV), parent vessel velocity, and oscillatory shear index (OSI). However, strong correlations were observed among normalized aneurysm wall shear stress (NWSS), low shear area (LSA), inflow concentration index (ICI), and normalized aneurysm velocity (NAV).

Conclusion Both morphological and hemodynamic assessments of IAs for silent MRA are comparable to 3DRA. Additionally, normalized indicators such as NWSS, LSA, ICI, and NAV were better than TAWSS, AV, and OSI in silent MRA-related hemodynamic evaluation.

  • Aneurysm
  • Angiography
  • Blood Flow
  • Magnetic Resonance Angiography

Data availability statement

All data relevant to the study are included in the article or uploaded as supplementary information.

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Data availability statement

All data relevant to the study are included in the article or uploaded as supplementary information.

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  • YL and XL contributed equally.

  • Contributors Conceptualization, methodology: YL, YW, RZ, ST, and XL. Data collection: YL, XH, CD, FG, and XZ. Software: RZ and QC. Visualization: YL and RZ. Writing – original draft preparation: YL. Writing – reviewing and editing: YW, WL, XL, and JX. All the authors listed have read and approved the manuscript. YW is responsible for the overall content as guarantor.

  • Funding This study was supported by National Natural Science Foundation of China (No. 81960330) (, Jiangxi Provincial Department of Science and Technology (Grant Number: 20202BABL206053, 20192BAB205045, 20161BBI90018).

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.