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Neuroimaging
Original research
Intracranial aneurysm wall displacement depicted by amplified Flow predicts growth
  1. Aymeric Pionteck1,
  2. Javid Abderezaei1,
  3. Patrick Fillingham2,
  4. Ya-Chen Chuang1,
  5. Yu Sakai3,
  6. Puneet Belani3,
  7. Brian Rigney3,
  8. Reade De Leacy4,
  9. Johanna T Fifi4,
  10. Aichi Chien5,
  11. Geoffrey P Colby6,
  12. Reza Jahan5,
  13. Gary Duckwiler5,
  14. James Sayre5,
  15. Samantha J Holdsworth7,
  16. Mahmud Mossa-Basha8,
  17. Michael R Levitt2,
  18. J Mocco4,
  19. Mehmet Kurt1,
  20. Kambiz Nael3,5
  1. 1Mechanical Engineering, University of Washington, Seattle, Washington, USA
  2. 2Neurological Surgery, University of Washington School of Medicine, Seattle, Washington, USA
  3. 3Diagnostic, Molecular and Interventional Radiology, Mount Sinai Health System, New York, New York, USA
  4. 4Neurosurgery, Icahn School of Medicine at Mount Sinai, New York, New York, USA
  5. 5Radiological Sciences, University of California, Los Angeles David Geffen School of Medicine, Los Angeles, California, USA
  6. 6Neurosurgery, University of California Los Angeles David Geffen School of Medicine, Los Angeles, California, USA
  7. 7Department of Anatomy, University of Auckland, Auckland, New Zealand
  8. 8Radiology, University of Washington School of Medicine, Seattle, Washington, USA
  1. Correspondence to Dr Kambiz Nael, Radiological Sciences, University of California Los Angeles David Geffen School of Medicine, Los Angeles, CA 90095, USA; kambiznael{at}gmail.com

Abstract

Background Abnormal intracranial aneurysm (IA) wall motion has been associated with IA growth and rupture. Recently, a new image processing algorithm called amplified Flow (aFlow) has been used to successfully track IA wall motion by combining the amplification of cine and four-dimensional (4D) Flow MRI. We sought to apply aFlow to assess wall motion as a potential marker of IA growth in a paired-wise analysis of patients with growing versus stable aneurysms.

Methods In this retrospective case–control study, 10 patients with growing IAs and a matched cohort of 10 patients with stable IAs who had baseline 4D Flow MRI were included. The aFlow was used to amplify and extract IA wall displacements from 4D Flow MRI. The associations of aFlow parameters with commonly used risk factors and morphometric features were assessed using paired-wise univariate and multivariate analyses.

Results aFlow quantitative results showed significantly (P=0.035) higher wall motion displacement depicted by mean±SD 90th% values of 2.34±0.72 in growing IAs versus 1.39±0.58 in stable IAs with an area under the curve of 0.85. There was also significantly (P<0.05) higher variability of wall deformation across IA geometry in growing versus stable IAs depicted by the dispersion variables including 121–150% larger standard deviation (Embedded Image) and 128–161% wider interquartile range Embedded Image.

Conclusions aFlow-derived quantitative assessment of IA wall motion showed greater wall motion and higher variability of wall deformation in growing versus stable IAs.

  • Aneurysm
  • Magnetic Resonance Angiography
  • MRI
  • Vessel Wall

Data availability statement

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

https://doi.org/10.1136/jnis-2023-021227

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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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    Footnotes

    • Twitter @rdeleacymd, @DrMichaelLevitt, @kambiznael

    • AP and JA contributed equally.

    • MK and KN contributed equally.

    • Contributors MK and KN contributed to the study conception, design and supervision and were joint last authors. The first draft of the manuscript was written by AP and JA, and these authors contributed equally to this work. Acquisition, analysis, or interpretation of data: all authors. Critical revision of the manuscript for important intellectual content: all authors. aFlow data analysis was performed by AP, JA, and MK. Image analysis was performed by PB, BR, KN. All authors read and approved the final manuscript. KN is the guarantor of the study.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • 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.