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<meta name="DC.Title" content="Additional Value of Intra-Aneurysmal Hemodynamics in Discriminating Ruptured versus Unruptured Intracranial Aneurysms" />
<meta name="DC.Identifier" content="10.3174/ajnr.A4397" />
<meta name="DC.Date" content="2015-10-01" />
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<meta name="DC.Description" content="BACKGROUND AND PURPOSE: Hemodynamics are thought to play an important role in the rupture of intracranial aneurysms. We tested whether hemodynamics, determined from computational fluid dynamics models, have additional value in discriminating ruptured and unruptured aneurysms. Such discriminative power could provide better prediction models for rupture.

MATERIALS AND METHODS: A cross-sectional study was performed on patients eligible for endovascular treatment, including 55 ruptured and 62 unruptured aneurysms. Association with rupture status was tested for location, aneurysm type, and 4 geometric and 10 hemodynamic parameters. Patient-specific spatiotemporal velocities measured with phase-contrast MR imaging were used as inflow conditions for computational fluid dynamics. To assess the additional value of hemodynamic parameters, we performed 1 univariate and 2 multivariate analyses: 1 traditional model including only location and geometry and 1 advanced model that included patient-specific hemodynamic parameters.

RESULTS: In the univariate analysis, high-risk locations (anterior cerebral arteries, posterior communicating artery, and posterior circulation), daughter sacs, unstable inflow jets, impingements at the aneurysm body, and unstable complex flow patterns were significantly present more often in ruptured aneurysms. In both multivariate analyses, only the high-risk location (OR, 3.92; 95% CI, 1.77–8.68) and the presence of daughter sacs (OR, 2.79; 95% CI, 1.25–6.25) remained as significant independent determinants.

CONCLUSIONS: In this study population of patients eligible for endovascular treatment, we found no independent additional value of aneurysmal hemodynamics in discriminating rupture status, despite high univariate associations. Only traditional parameters (high-risk location and the presence of daughter sacs) were independently associated with ruptured aneurysms.

CFD
:   computational fluid dynamics
3DRA
:   3D rotational angiography
PC
:   phase-contrast" />
<meta name="DC.Contributor" content="J.J. Schneiders" />
<meta name="DC.Contributor" content="H.A. Marquering" />
<meta name="DC.Contributor" content="P. van Ooij" />
<meta name="DC.Contributor" content="R. van den Berg" />
<meta name="DC.Contributor" content="A.J. Nederveen" />
<meta name="DC.Contributor" content="D. Verbaan" />
<meta name="DC.Contributor" content="W.P. Vandertop" />
<meta name="DC.Contributor" content="M. Pourquie" />
<meta name="DC.Contributor" content="G.J.E. Rinkel" />
<meta name="DC.Contributor" content="E. vanBavel" />
<meta name="DC.Contributor" content="C.B.L.M. Majoie" />
<meta name="article:published_time" content="2015-10-01" />
<meta name="article:section" content="INTERVENTIONAL" />
<meta name="citation_title" content="Additional Value of Intra-Aneurysmal Hemodynamics in Discriminating Ruptured versus Unruptured Intracranial Aneurysms" />
<meta name="citation_abstract" lang="en" content="&lt;h3&gt;BACKGROUND AND PURPOSE:&lt;/h3&gt;
&lt;p&gt;Hemodynamics are thought to play an important role in the rupture of intracranial aneurysms. We tested whether hemodynamics, determined from computational fluid dynamics models, have additional value in discriminating ruptured and unruptured aneurysms. Such discriminative power could provide better prediction models for rupture.&lt;/p&gt;&lt;h3&gt;MATERIALS AND METHODS:&lt;/h3&gt;
&lt;p&gt;A cross-sectional study was performed on patients eligible for endovascular treatment, including 55 ruptured and 62 unruptured aneurysms. Association with rupture status was tested for location, aneurysm type, and 4 geometric and 10 hemodynamic parameters. Patient-specific spatiotemporal velocities measured with phase-contrast MR imaging were used as inflow conditions for computational fluid dynamics. To assess the additional value of hemodynamic parameters, we performed 1 univariate and 2 multivariate analyses: 1 traditional model including only location and geometry and 1 advanced model that included patient-specific hemodynamic parameters.&lt;/p&gt;&lt;h3&gt;RESULTS:&lt;/h3&gt;
&lt;p&gt;In the univariate analysis, high-risk locations (anterior cerebral arteries, posterior communicating artery, and posterior circulation), daughter sacs, unstable inflow jets, impingements at the aneurysm body, and unstable complex flow patterns were significantly present more often in ruptured aneurysms. In both multivariate analyses, only the high-risk location (OR, 3.92; 95% CI, 1.77–8.68) and the presence of daughter sacs (OR, 2.79; 95% CI, 1.25–6.25) remained as significant independent determinants.&lt;/p&gt;&lt;h3&gt;CONCLUSIONS:&lt;/h3&gt;
&lt;p&gt;In this study population of patients eligible for endovascular treatment, we found no independent additional value of aneurysmal hemodynamics in discriminating rupture status, despite high univariate associations. Only traditional parameters (high-risk location and the presence of daughter sacs) were independently associated with ruptured aneurysms.&lt;/p&gt;" />
<meta name="citation_journal_title" content="American Journal of Neuroradiology" />
<meta name="citation_publisher" content="American Journal of Neuroradiology" />
<meta name="citation_publication_date" content="2015/10/01" />
<meta name="citation_mjid" content="ajnr;36/10/1920" />
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<meta name="citation_issn" content="0195-6108" />
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<meta name="citation_section" content="INTERVENTIONAL" />
<meta name="citation_firstpage" content="1920" />
<meta name="citation_lastpage" content="1926" />
<meta name="citation_author" content="J.J. Schneiders" />
<meta name="citation_author_institution" content="aFrom the Departments of Radiology (J.J.S., H.A.M., P.v.O., R.v.d.B., A.J.N., C.B.L.M.M.)" />
<meta name="citation_author" content="H.A. Marquering" />
<meta name="citation_author_institution" content="aFrom the Departments of Radiology (J.J.S., H.A.M., P.v.O., R.v.d.B., A.J.N., C.B.L.M.M.)" />
<meta name="citation_author_institution" content="bBiomedical Engineering and Physics (H.A.M., E.V.)" />
<meta name="citation_author" content="P. van Ooij" />
<meta name="citation_author_institution" content="aFrom the Departments of Radiology (J.J.S., H.A.M., P.v.O., R.v.d.B., A.J.N., C.B.L.M.M.)" />
<meta name="citation_author" content="R. van den Berg" />
<meta name="citation_author_institution" content="aFrom the Departments of Radiology (J.J.S., H.A.M., P.v.O., R.v.d.B., A.J.N., C.B.L.M.M.)" />
<meta name="citation_author" content="A.J. Nederveen" />
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<meta name="citation_reference" content="citation_journal_title=New England Journal of Medicine;citation_journal_abbrev=NEJM;citation_author=JL. Brisman;citation_author=JK. Song;citation_author=DW. Newell;citation_title=Cerebral aneurysms.;citation_pages=928-939;citation_volume=355;citation_year=2006;citation_issue=9;citation_pmid=16943405;citation_doi=10.1056/NEJMra052760" />
<meta name="citation_reference" content="citation_journal_title=Lancet;citation_journal_abbrev=Lancet;citation_author=International Study of Unruptured Intracranial Aneurysms Investigators;citation_title=Unruptured intracranial aneurysms: natural history, clinical outcome, and risks of surgical and endovascular treatment.;citation_pages=103-110;citation_volume=362;citation_year=2003;citation_issue=9378;citation_pmid=12867109;citation_doi=10.1016/S0140-6736(03)13860-3" />
<meta name="citation_reference" content="citation_journal_title=Lancet Neurol;citation_author=JP. Greving;citation_author=MJ. Wermer;citation_author=RD. Brown;citation_title=Development of the PHASES score for prediction of risk of rupture of intracranial aneurysms: a pooled analysis of six prospective cohort studies;citation_pages=59-66;citation_volume=13;citation_year=2014;citation_pmid=24290159;citation_doi=10.1016/S1474-4422(13)70263-1" />
<meta name="citation_reference" content="citation_journal_title=Stroke;citation_author=MJ. Wermer;citation_author=IC. van der Schaaf;citation_author=A. Algra;citation_title=Risk of rupture of unruptured intracranial aneurysms in relation to patient and aneurysm characteristics: an updated meta-analysis;citation_volume=38;citation_year=2007;citation_pmid=17332442;citation_doi=10.1161/01.STR.0000260955.51401.cd" />
<meta name="citation_reference" content="citation_journal_title=Neurosurgery;citation_journal_abbrev=Neurosurgery;citation_author=TR. Forget;citation_author=R. Benitez;citation_author=E. Veznedaroglu;citation_title=A review of size and location of ruptured intracranial aneurysms.;citation_pages=1322-1325;citation_volume=49;citation_year=2001;citation_issue=6;citation_pmid=11846931;citation_doi=10.1097/00006123-200112000-00006" />
<meta name="citation_reference" content="citation_journal_title=Stroke;citation_author=Y. Miura;citation_author=F. Ishida;citation_author=Y. Umeda;citation_title=Low wall shear stress is independently associated with the rupture status of middle cerebral artery aneurysms;citation_volume=44;citation_year=2013;citation_pmid=23223503;citation_doi=10.1161/STROKEAHA.112.675306" />
<meta name="citation_reference" content="citation_journal_title=AJNR Am J Neuroradiol;citation_author=JR. Cebral;citation_author=F. Mut;citation_author=J. Weir;citation_title=Association of hemodynamic characteristics and cerebral aneurysm rupture;citation_volume=32;citation_year=2011;citation_pmid=21051508;citation_doi=10.3174/ajnr.A2274" />
<meta name="citation_reference" content="citation_journal_title=American Journal of Neuroradiology;citation_journal_abbrev=Am. J. Neuroradiol.;citation_author=JR. Cebral;citation_author=MA. Castro;citation_author=JE. Burgess;citation_title=Characterization of Cerebral Aneurysms for Assessing Risk of Rupture By Using Patient-Specific Computational Hemodynamics Models;citation_pages=2550-2559;citation_volume=26;citation_year=2005;citation_issue=10;citation_pmid=16286400" />
<meta name="citation_reference" content="citation_journal_title=Stroke;citation_author=J. Xiang;citation_author=SK. Natarajan;citation_author=M. Tremmel;citation_title=Hemodynamic-morphologic discriminants for intracranial aneurysm rupture;citation_volume=42;citation_year=2011;citation_pmid=21106956;citation_doi=10.1161/STROKEAHA.110.592923" />
<meta name="citation_reference" content="citation_journal_title=AJNR Am J Neuroradiol;citation_author=JJ. Schneiders;citation_author=SP. Ferns;citation_author=P. van Ooij;citation_title=Comparison of phase-contrast MR imaging and endovascular sonography for intracranial blood flow velocity measurements;citation_volume=33;citation_year=2012;citation_pmid=22576898;citation_doi=10.3174/ajnr.A3142" />
<meta name="citation_reference" content="citation_journal_title=Journal of biomechanics;citation_journal_abbrev=J Biomech;citation_author=AG. Radaelli;citation_author=L. Augsburger;citation_author=JR. Cebral;citation_title=Reproducibility of haemodynamical simulations in a subject-specific stented aneurysm model--a report on the Virtual Intracranial Stenting Challenge 2007.;citation_pages=2069-2081;citation_volume=41;citation_year=2008;citation_issue=10;citation_pmid=18582891;citation_doi=10.1016/j.jbiomech.2008.04.035" />
<meta name="citation_reference" content="citation_journal_title=Journal of neurosurgery;citation_journal_abbrev=J Neurosurg;citation_author=P. Venugopal;citation_author=D. Valentino;citation_author=H. Schmitt;citation_title=Sensitivity of patient-specific numerical simulation of cerebal aneurysm hemodynamics to inflow boundary conditions.;citation_pages=1051-1060;citation_volume=106;citation_year=2007;citation_issue=6;citation_pmid=17564178;citation_doi=10.3171/jns.2007.106.6.1051" />
<meta name="citation_reference" content="citation_journal_title=Annals of biomedical engineering;citation_journal_abbrev=Ann Biomed Eng;citation_author=A. Marzo;citation_author=P. Singh;citation_author=I. Larrabide;citation_title=Computational hemodynamics in cerebral aneurysms: the effects of modeled versus measured boundary conditions.;citation_pages=884-896;citation_volume=39;citation_year=2011;citation_issue=2;citation_pmid=20972626;citation_doi=10.1007/s10439-010-0187-z" />
<meta name="citation_reference" content="citation_journal_title=AJNR Am J Neuroradiol;citation_author=IG. Jansen;citation_author=JJ. Schneiders;citation_author=WV. Potters;citation_title=Generalized versus patient-specific inflow boundary conditions in computational fluid dynamics simulations of cerebral aneurysmal hemodynamics;citation_volume=35;citation_year=2014;citation_pmid=24651816;citation_doi=10.3174/ajnr.A3901" />
<meta name="citation_reference" content="citation_journal_title=AJNR Am J Neuroradiol;citation_author=P. van Ooij;citation_author=JJ. Schneiders;citation_author=HA. Marquering;citation_title=3D cine phase-contrast MRI at 3T in intracranial aneurysms compared with patient-specific computational fluid dynamics;citation_volume=34;citation_year=2013;citation_pmid=23598829;citation_doi=10.3174/ajnr.A3484" />
<meta name="citation_reference" content="citation_journal_title=IEEE transactions on medical imaging;citation_journal_abbrev=IEEE Trans Med Imaging;citation_author=M. Piccinelli;citation_author=A. Veneziani;citation_author=DA. Steinman;citation_title=A framework for geometric analysis of vascular structures: application to cerebral aneurysms.;citation_pages=1141-1155;citation_volume=28;citation_year=2009;citation_issue=8;citation_pmid=19447701;citation_doi=10.1109/TMI.2009.2021652" />
<meta name="citation_reference" content="citation_journal_title=AJNR Am J Neuroradiol;citation_author=JJ. Schneiders;citation_author=HA. Marquering;citation_author=L. Antiga;citation_title=Intracranial aneurysm neck size overestimation with 3D rotational angiography: the impact on intra-aneurysmal hemodynamics simulated with computational fluid dynamics;citation_volume=34;citation_year=2013;citation_pmid=22899789;citation_doi=10.3174/ajnr.A3179" />
<meta name="citation_reference" content="citation_journal_title=IEEE transactions on medical imaging;citation_journal_abbrev=IEEE Trans Med Imaging;citation_author=JR. Cebral;citation_author=MA. Castro;citation_author=S. Appanaboyina;citation_title=Efficient pipeline for image-based patient-specific analysis of cerebral aneurysm hemodynamics: technique and sensitivity.;citation_pages=457-467;citation_volume=24;citation_year=2005;citation_issue=4;citation_pmid=15822804;citation_doi=10.1109/TMI.2005.844159" />
<meta name="citation_reference" content="citation_journal_title=Journal of neurology;citation_journal_abbrev=J Neurol;citation_author=NK. de Rooij;citation_author=BK. Velthuis;citation_author=A. Algra;citation_title=Configuration of the circle of Willis, direction of flow, and shape of the aneurysm as risk factors for rupture of intracranial aneurysms.;citation_pages=45-50;citation_volume=256;citation_year=2009;citation_issue=1;citation_pmid=19221852;citation_doi=10.1007/s00415-009-0028-x" />
<meta name="citation_reference" content="citation_journal_title=Neurosurgery;citation_journal_abbrev=Neurosurgery;citation_author=S. Dhar;citation_author=M. Tremmel;citation_author=J. Mocco;citation_title=Morphology parameters for intracranial aneurysm rupture risk assessment.;citation_pages=185-196;citation_volume=63;citation_year=2008;citation_issue=2;citation_pmid=18797347;citation_doi=10.1227/01.NEU.0000316847.64140.81" />
<meta name="citation_reference" content="citation_journal_title=Ann Biomed Eng;citation_author=JR. Cebral;citation_author=M. Raschi;citation_title=Suggested connections between risk factors of intracranial aneurysms: a review;citation_pages=1366-83;citation_volume=41;citation_year=2013;citation_pmid=23242844;citation_doi=10.1007/s10439-012-0723-0" />
<meta name="citation_reference" content="citation_journal_title=Acta neurochirurgica;citation_journal_abbrev=Acta Neurochir (Wien);citation_author=J. Beck;citation_author=S. Rohde;citation_author=M. el Beltagy;citation_title=Difference in configuration of ruptured and unruptured intracranial aneurysms determined by biplanar digital subtraction angiography.;citation_pages=861-865;citation_volume=145;citation_year=2003;citation_issue=10;citation_pmid=14577007;citation_doi=10.1007/s00701-003-0124-0" />
<meta name="citation_reference" content="citation_journal_title=New England Journal of Medicine;citation_journal_abbrev=NEJM;citation_author=UCAS Japan Investigators;citation_title=The natural course of unruptured cerebral aneurysms in a Japanese cohort.;citation_pages=2474-2482;citation_volume=366;citation_year=2012;citation_issue=26;citation_pmid=22738097;citation_doi=10.1056/NEJMoa1113260" />
<meta name="citation_reference" content="citation_journal_title=AJNR Am J Neuroradiol;citation_author=JJ. Schneiders;citation_author=HA. Marquering;citation_author=R. van den Berg;citation_title=Rupture-associated changes of cerebral aneurysm geometry: high-resolution 3D imaging before and after rupture;citation_volume=35;citation_year=2014;citation_pmid=24557706;citation_doi=10.3174/ajnr.A3866" />
<meta name="citation_reference" content="citation_journal_title=Neurosurgery;citation_journal_abbrev=Neurosurgery;citation_author=M. Rahman;citation_author=CS. Ogilvy;citation_author=GJ. Zipfel;citation_title=Unruptured cerebral aneurysms do not shrink when they rupture: multicenter collaborative aneurysm study group.;citation_pages=155-160;citation_volume=68;citation_year=2011;citation_issue=1;citation_pmid=21150760;citation_doi=10.1227/NEU.0b013e3181ff357c" />
<meta name="citation_reference" content="citation_journal_title=Journal of neurosurgery;citation_journal_abbrev=J Neurosurg;citation_author=MI. Baharoglu;citation_author=A. Lauric;citation_author=BL. Gao;citation_title=Identification of a dichotomy in morphological predictors of rupture status between sidewall- and bifurcation-type intracranial aneurysms.;citation_pages=871-881;citation_volume=116;citation_year=2012;citation_issue=4;citation_pmid=22242668;citation_doi=10.3171/2011.11.JNS11311" />
<meta name="citation_reference" content="citation_journal_title=Med Image Comput Comput Assist Interv;citation_author=L. Dempere-Marco;citation_author=E. Oubel;citation_author=M. Castro;citation_title=CFD analysis incorporating the influence of wall motion: application to intracranial aneurysms;citation_pages=438-45;citation_volume=9;citation_year=2006;citation_issue=pt 2;citation_pmid=17354802" />
<meta name="citation_reference" content="citation_journal_title=AJNR Am J Neuroradiol;citation_author=K. Valen-Sendstad;citation_author=DA. Steinman;citation_title=Mind the gap: impact of computational fluid dynamics solution strategy on prediction of intracranial aneurysm hemodynamics and rupture status indicators;citation_volume=35;citation_year=2014;citation_pmid=24231854;citation_doi=10.3174/ajnr.A3793" />
<meta name="citation_reference" content="citation_journal_title=Stroke;citation_author=M. Sonobe;citation_author=T. Yamazaki;citation_author=M. Yonekura;citation_title=Small unruptured intracranial aneurysm verification study: SUAVe study, Japan;citation_volume=41;citation_year=2010;citation_pmid=20671254;citation_doi=10.1161/STROKEAHA.110.585059" />
<meta name="citation_reference" content="citation_journal_title=Stroke;citation_author=T. Ishibashi;citation_author=Y. Murayama;citation_author=M. Urashima;citation_title=Unruptured intracranial aneurysms: incidence of rupture and risk factors;citation_volume=40;citation_year=2009;citation_pmid=18845802;citation_doi=10.1161/STROKEAHA.108.521674" />
<meta name="twitter:title" content="Additional Value of Intra-Aneurysmal Hemodynamics in Discriminating Ruptured versus Unruptured Intracranial Aneurysms" />
<meta name="twitter:card" content="summary_large_image" />
<meta name="twitter:image" content="http://ajnr-stage2.stage.highwire.org/sites/default/files/highwire/ajnr/36/10.cover-source.jpg" />
<meta name="twitter:description" content="BACKGROUND AND PURPOSE: Hemodynamics are thought to play an important role in the rupture of intracranial aneurysms. We tested whether hemodynamics, determined from computational fluid dynamics models, have additional value in discriminating ruptured and unruptured aneurysms. Such discriminative power could provide better prediction models for rupture.

MATERIALS AND METHODS: A cross-sectional study was performed on patients eligible for endovascular treatment, including 55 ruptured and 62 unruptured aneurysms. Association with rupture status was tested for location, aneurysm type, and 4 geometric and 10 hemodynamic parameters. Patient-specific spatiotemporal velocities measured with phase-contrast MR imaging were used as inflow conditions for computational fluid dynamics. To assess the additional value of hemodynamic parameters, we performed 1 univariate and 2 multivariate analyses: 1 traditional model including only location and geometry and 1 advanced model that included patient-specific hemodynamic parameters.

RESULTS: In the univariate analysis, high-risk locations (anterior cerebral arteries, posterior communicating artery, and posterior circulation), daughter sacs, unstable inflow jets, impingements at the aneurysm body, and unstable complex flow patterns were significantly present more often in ruptured aneurysms. In both multivariate analyses, only the high-risk location (OR, 3.92; 95% CI, 1.77–8.68) and the presence of daughter sacs (OR, 2.79; 95% CI, 1.25–6.25) remained as significant independent determinants.

CONCLUSIONS: In this study population of patients eligible for endovascular treatment, we found no independent additional value of aneurysmal hemodynamics in discriminating rupture status, despite high univariate associations. Only traditional parameters (high-risk location and the presence of daughter sacs) were independently associated with ruptured aneurysms.

CFD
:   computational fluid dynamics
3DRA
:   3D rotational angiography
PC
:   phase-contrast" />
<meta name="og-title" property="og:title" content="Additional Value of Intra-Aneurysmal Hemodynamics in Discriminating Ruptured versus Unruptured Intracranial Aneurysms" />
<meta name="og-url" property="og:url" content="http://ajnr-stage2.stage.highwire.org/content/36/10/1920" />
<meta name="og-site-name" property="og:site_name" content="American Journal of Neuroradiology" />
<meta name="og-description" property="og:description" content="BACKGROUND AND PURPOSE: Hemodynamics are thought to play an important role in the rupture of intracranial aneurysms. We tested whether hemodynamics, determined from computational fluid dynamics models, have additional value in discriminating ruptured and unruptured aneurysms. Such discriminative power could provide better prediction models for rupture.

MATERIALS AND METHODS: A cross-sectional study was performed on patients eligible for endovascular treatment, including 55 ruptured and 62 unruptured aneurysms. Association with rupture status was tested for location, aneurysm type, and 4 geometric and 10 hemodynamic parameters. Patient-specific spatiotemporal velocities measured with phase-contrast MR imaging were used as inflow conditions for computational fluid dynamics. To assess the additional value of hemodynamic parameters, we performed 1 univariate and 2 multivariate analyses: 1 traditional model including only location and geometry and 1 advanced model that included patient-specific hemodynamic parameters.

RESULTS: In the univariate analysis, high-risk locations (anterior cerebral arteries, posterior communicating artery, and posterior circulation), daughter sacs, unstable inflow jets, impingements at the aneurysm body, and unstable complex flow patterns were significantly present more often in ruptured aneurysms. In both multivariate analyses, only the high-risk location (OR, 3.92; 95% CI, 1.77–8.68) and the presence of daughter sacs (OR, 2.79; 95% CI, 1.25–6.25) remained as significant independent determinants.

CONCLUSIONS: In this study population of patients eligible for endovascular treatment, we found no independent additional value of aneurysmal hemodynamics in discriminating rupture status, despite high univariate associations. Only traditional parameters (high-risk location and the presence of daughter sacs) were independently associated with ruptured aneurysms.

CFD
:   computational fluid dynamics
3DRA
:   3D rotational angiography
PC
:   phase-contrast" />
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    <div class="highwire-article-citation highwire-citation-type-highwire-article node14064--5" data-node-nid="14064" id="top-node-14064--654002346" data-pisa="ajnr;36/10/1920" data-pisa-master="ajnr;ajnr.A4397" data-apath="/ajnr/36/10/1920.atom" data-hw-author-tooltip-instance="highwire_author_tooltip"><div class="highwire-cite highwire-cite-highwire-article highwire-citation-jcore-article-title-complete clearfix has-author-tooltip highwire-citation-highwire-article-top-a">
  
  
      <div class="highwire-cite-overline"><span  class="highwire-cite-metadata-article-type highwire-cite-metadata">Research Article</span><span class="separator-pipe"></span><span  class="highwire-cite-metadata-art-cat highwire-cite-metadata"><span class="wrapper">INTERVENTIONAL</span></span></div>
  
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      <h1 class="highwire-cite-title" id="page-title">Additional Value of Intra-Aneurysmal Hemodynamics in Discriminating Ruptured versus Unruptured Intracranial Aneurysms</h1>  
    	<div class="highwire-cite-authors"><span  class="highwire-citation-authors"><span class="highwire-citation-author first" data-delta="0">J.J. Schneiders</span>, <span class="highwire-citation-author" data-delta="1">H.A. Marquering</span>, <span class="highwire-citation-author" data-delta="2">P. van Ooij</span>, <span class="highwire-citation-author" data-delta="3">R. van den Berg</span>, <span class="highwire-citation-author" data-delta="4">A.J. Nederveen</span>, <span class="highwire-citation-author" data-delta="5">D. Verbaan</span>, <span class="highwire-citation-author" data-delta="6">W.P. Vandertop</span>, <span class="highwire-citation-author" data-delta="7">M. Pourquie</span>, <span class="highwire-citation-author" data-delta="8">G.J.E. Rinkel</span>, <span class="highwire-citation-author" data-delta="9">E. vanBavel</span> and <span class="highwire-citation-author" data-delta="10">C.B.L.M. Majoie</span></span></div>
  
    	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-journal highwire-cite-metadata">American Journal of Neuroradiology </span><span  class="highwire-cite-metadata-date highwire-cite-metadata">October 2015,  </span><span  class="highwire-cite-metadata-volume highwire-cite-metadata">36 </span><span  class="highwire-cite-metadata-issue highwire-cite-metadata">(10) </span><span  class="highwire-cite-metadata-pages highwire-cite-metadata">1920-1926; </span><span  class="highwire-cite-metadata-doi highwire-cite-metadata">DOI: https://doi.org/10.3174/ajnr.A4397 </span></div>
  
  
  
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<div id="hw-article-author-popups-top-node-14064--654002346" style="display: none;"><div class="author-tooltip-0"><div class="author-tooltip-name">J.J. Schneiders </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>a</span>From the Departments of Radiology (J.J.S., H.A.M., P.v.O., R.v.d.B., A.J.N., C.B.L.M.M.)</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=J.J.%2BSchneiders%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Schneiders%20J&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link last"><a href="/search/author1%3AJ.J.%2BSchneiders%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li></ul></div><div class="author-tooltip-1"><div class="author-tooltip-name">H.A. Marquering </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>a</span>From the Departments of Radiology (J.J.S., H.A.M., P.v.O., R.v.d.B., A.J.N., C.B.L.M.M.)</div><div class='author-affiliation'><span class='nlm-sup'>b</span>Biomedical Engineering and Physics (H.A.M., E.V.)</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=H.A.%2BMarquering%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Marquering%20H&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link last"><a href="/search/author1%3AH.A.%2BMarquering%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li></ul></div><div class="author-tooltip-2"><div class="author-tooltip-name">P. van Ooij </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>a</span>From the Departments of Radiology (J.J.S., H.A.M., P.v.O., R.v.d.B., A.J.N., C.B.L.M.M.)</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=P.%2Bvan%2BOoij%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=van%20Ooij%20P&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link last"><a href="/search/author1%3AP.%2Bvan%2BOoij%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li></ul></div><div class="author-tooltip-3"><div class="author-tooltip-name">R. van den Berg </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>a</span>From the Departments of Radiology (J.J.S., H.A.M., P.v.O., R.v.d.B., A.J.N., C.B.L.M.M.)</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=R.%2Bvan%2Bden%2BBerg%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=van%20den%20Berg%20R&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link last"><a href="/search/author1%3AR.%2Bvan%2Bden%2BBerg%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li></ul></div><div class="author-tooltip-4"><div class="author-tooltip-name">A.J. Nederveen </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>a</span>From the Departments of Radiology (J.J.S., H.A.M., P.v.O., R.v.d.B., A.J.N., C.B.L.M.M.)</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=A.J.%2BNederveen%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Nederveen%20A&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link last"><a href="/search/author1%3AA.J.%2BNederveen%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li></ul></div><div class="author-tooltip-5"><div class="author-tooltip-name">D. Verbaan </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>c</span>Neurosurgery (D.V., W.P.V.), Academic Medical Center, Amsterdam, the Netherlands</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=D.%2BVerbaan%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Verbaan%20D&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link last"><a href="/search/author1%3AD.%2BVerbaan%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li></ul></div><div class="author-tooltip-6"><div class="author-tooltip-name">W.P. Vandertop </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>c</span>Neurosurgery (D.V., W.P.V.), Academic Medical Center, Amsterdam, the Netherlands</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=W.P.%2BVandertop%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Vandertop%20W&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link last"><a href="/search/author1%3AW.P.%2BVandertop%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li></ul></div><div class="author-tooltip-7"><div class="author-tooltip-name">M. Pourquie </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>d</span>Department of Aero- and Hydrodynamics (M.P.), Delft University of Technology, Delft, the Netherlands</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=M.%2BPourquie%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Pourquie%20M&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link last"><a href="/search/author1%3AM.%2BPourquie%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li></ul></div><div class="author-tooltip-8"><div class="author-tooltip-name">G.J.E. 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    <div class="highwire-markup"><div xmlns="http://www.w3.org/1999/xhtml" data-highwire-cite-ref-tooltip-instance="highwire_reflinks_tooltip" class="content-block-markup" xmlns:xhtml="http://www.w3.org/1999/xhtml"><div class="article abstract-view "><span class="highwire-journal-article-marker-start"></span><div class="section abstract" id="abstract-1"><h2>Abstract</h2><div id="sec-1" class="subsection"><p id="p-2"><strong>BACKGROUND AND PURPOSE:</strong> Hemodynamics are thought to play an important role in the rupture of intracranial aneurysms. We tested whether hemodynamics, determined from computational fluid dynamics models, have additional value in discriminating ruptured and unruptured aneurysms. Such discriminative power could provide better prediction models for rupture.</p></div><div id="sec-2" class="subsection"><p id="p-3"><strong>MATERIALS AND METHODS:</strong> A cross-sectional study was performed on patients eligible for endovascular treatment, including 55 ruptured and 62 unruptured aneurysms. Association with rupture status was tested for location, aneurysm type, and 4 geometric and 10 hemodynamic parameters. Patient-specific spatiotemporal velocities measured with phase-contrast MR imaging were used as inflow conditions for computational fluid dynamics. To assess the additional value of hemodynamic parameters, we performed 1 univariate and 2 multivariate analyses: 1 traditional model including only location and geometry and 1 advanced model that included patient-specific hemodynamic parameters.</p></div><div id="sec-3" class="subsection"><p id="p-4"><strong>RESULTS:</strong> In the univariate analysis, high-risk locations (anterior cerebral arteries, posterior communicating artery, and posterior circulation), daughter sacs, unstable inflow jets, impingements at the aneurysm body, and unstable complex flow patterns were significantly present more often in ruptured aneurysms. In both multivariate analyses, only the high-risk location (OR, 3.92; 95% CI, 1.77–8.68) and the presence of daughter sacs (OR, 2.79; 95% CI, 1.25–6.25) remained as significant independent determinants.</p></div><div id="sec-4" class="subsection"><p id="p-5"><strong>CONCLUSIONS:</strong> In this study population of patients eligible for endovascular treatment, we found no independent additional value of aneurysmal hemodynamics in discriminating rupture status, despite high univariate associations. Only traditional parameters (high-risk location and the presence of daughter sacs) were independently associated with ruptured aneurysms.</p></div></div><div class="section glossary" id="glossary-1"><h2 class="">ABBREVIATIONS:</h2><dl id="def-list-1"><dt id="def-item-1">CFD<span class="def-item-dt-sep"></span></dt><dd>computational fluid dynamics<span class="def-item-dd-sep"></span></dd><dt id="def-item-2">3DRA<span class="def-item-dt-sep"></span></dt><dd>3D rotational angiography<span class="def-item-dd-sep"></span></dd><dt id="def-item-3">PC<span class="def-item-dt-sep"></span></dt><dd>phase-contrast</dd></dl></div><ul class="copyright-statement"><li class="fn" id="copyright-statement-1">© 2015 by American Journal of Neuroradiology</li></ul><span class="highwire-journal-article-marker-end"></span></div><span class="related-urls"></span></div><a href="http://ajnr-stage2.stage.highwire.org/content/36/10/1920.full" class="hw-link hw-link-article-full-text" data-icon-position="" data-hide-link-title="0">View Full Text</a></div>  </div>

  
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        	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-volume highwire-cite-metadata">Vol. 36</span>, <span  class="highwire-cite-metadata-issue highwire-cite-metadata">Issue 10 </span><div  class="highwire-cite-metadata-pubdate highwire-cite-metadata">1 Oct 2015 </div></div>
      
      
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    	<div class="highwire-cite-authors"><span  class="highwire-citation-authors"><span class="highwire-citation-author first" data-delta="0"><span class="nlm-given-names">J.J.</span> <span class="nlm-surname">Schneiders</span></span>, <span class="highwire-citation-author" data-delta="1"><span class="nlm-given-names">H.A.</span> <span class="nlm-surname">Marquering</span></span>, <span class="highwire-citation-author" data-delta="2"><span class="nlm-given-names">P.</span> <span class="nlm-surname">van Ooij</span></span>, <span class="highwire-citation-author" data-delta="3"><span class="nlm-given-names">R.</span> <span class="nlm-surname">van den Berg</span></span>, <span class="highwire-citation-author" data-delta="4"><span class="nlm-given-names">A.J.</span> <span class="nlm-surname">Nederveen</span></span>, <span class="highwire-citation-author" data-delta="5"><span class="nlm-given-names">D.</span> <span class="nlm-surname">Verbaan</span></span>, <span class="highwire-citation-author" data-delta="6"><span class="nlm-given-names">W.P.</span> <span class="nlm-surname">Vandertop</span></span>, <span class="highwire-citation-author" data-delta="7"><span class="nlm-given-names">M.</span> <span class="nlm-surname">Pourquie</span></span>, <span class="highwire-citation-author" data-delta="8"><span class="nlm-given-names">G.J.E.</span> <span class="nlm-surname">Rinkel</span></span>, <span class="highwire-citation-author" data-delta="9"><span class="nlm-given-names">E.</span> <span class="nlm-surname">vanBavel</span></span>, <span class="highwire-citation-author" data-delta="10"><span class="nlm-given-names">C.B.L.M.</span> <span class="nlm-surname">Majoie</span></span></span></div>
  
    	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-journal highwire-cite-metadata">American Journal of Neuroradiology </span><span  class="highwire-cite-metadata-date highwire-cite-metadata">Oct 2015, </span><span  class="highwire-cite-metadata-volume highwire-cite-metadata">36 </span><span  class="highwire-cite-metadata-issue highwire-cite-metadata">(10) </span><span  class="highwire-cite-metadata-pages highwire-cite-metadata">1920-1926; </span><span  class="highwire-cite-metadata-doi highwire-cite-metadata"><span class="label">DOI:</span> 10.3174/ajnr.A4397 </span></div>
  
  
  
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    	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-journal highwire-cite-metadata">American Journal of Neuroradiology </span><span  class="highwire-cite-metadata-date highwire-cite-metadata">Oct 2015, </span><span  class="highwire-cite-metadata-volume highwire-cite-metadata">36 </span><span  class="highwire-cite-metadata-issue highwire-cite-metadata">(10) </span><span  class="highwire-cite-metadata-pages highwire-cite-metadata">1920-1926; </span><span  class="highwire-cite-metadata-doi highwire-cite-metadata"><span class="label">DOI:</span> 10.3174/ajnr.A4397 </span></div>
  
  
  
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