Advanced technologies applied to physiopathological analysis of central nervous system aneurysms and vascular malformations

M Edjlali; P Roca; J-C Gentric; D Trystram; C Rodriguez-Régent; F Nataf; F Chrétien; O Wieben; P Turski; J-F Meder; O Naggara; C Oppenheim

doi:10.1016/j.diii.2014.05.003

Advanced technologies applied to physiopathological analysis of central nervous system aneurysms and vascular malformations

Diagn Interv Imaging. 2014 Dec;95(12):1187-93. doi: 10.1016/j.diii.2014.05.003. Epub 2014 Jun 3.

Authors

M Edjlali¹, P Roca², J-C Gentric³, D Trystram², C Rodriguez-Régent², F Nataf⁴, F Chrétien⁵, O Wieben⁶, P Turski⁶, J-F Meder², O Naggara⁷, C Oppenheim²

Affiliations

¹ Département de neuroradiologie, hôpital Sainte-Anne, 1, rue Cabanis, 75014 Paris, France. Electronic address: m.edjlali@ch-sainte-anne.fr.
² Département de neuroradiologie, hôpital Sainte-Anne, 1, rue Cabanis, 75014 Paris, France.
³ Département de neuroradiologie, hôpital universitaire de Montréal, Québec, Canada.
⁴ Département de neurochirurgie, hôpital Sainte-Anne, 1, rue Cabanis, 75014 Paris, France.
⁵ Département d'anatomopathologie, hôpital Sainte-Anne, 1, rue Cabanis, 75014 Paris, France.
⁶ Département de physique médicale (O.W.) et de radiologie (P.T.), université du Wisconsin, Madison, Wisconsin, United States.
⁷ Département de neuroradiologie, hôpital Sainte-Anne, 1, rue Cabanis, 75014 Paris, France; Département de neuroradiologie (O.N.), hôpital Necker, AP-HP, 149, rue de Sèvres, 75015 Paris, France.

PMID: 24933269
DOI: 10.1016/j.diii.2014.05.003

Abstract

While depiction and definition of morphological and architectural characteristics of CNS vascular disorders remains the first step of an MR analysis, emerging imaging techniques offer new functional information that might help to characterize rupture risk of CNS vascular disorders. Two main orientations are suggested by recent studies: inflammation of the vessel wall and analysis of physical constraints of blood flow using 4D flow imaging (shear parietal). This paper will focus on radiological application of 4D flow imaging and inflammation imaging, in the characterization of potential prognostic markers of CNS vascular disorders. We will review the basic technical considerations of 4D flow MRA, inflammation imaging and discuss their applications in CNS vascular disorders: aneurysms, arteriovenous malformation, dural arteriovenous fistulas. We will illustrate their potential in the development of individual rupture risk criteria in brain vascular disorders.

Keywords: 4D flow MRI; Advanced MR techniques; Brain vascular disorders; Inflammation imaging.

MeSH terms

Central Nervous System Vascular Malformations / diagnosis
Central Nervous System Vascular Malformations / physiopathology*
Hemodynamics / physiology*
Humans
Image Enhancement / methods*
Image Interpretation, Computer-Assisted / methods*
Imaging, Three-Dimensional / methods
Intracranial Aneurysm / diagnosis
Intracranial Aneurysm / physiopathology*
Magnetic Resonance Angiography / methods*
Muscle, Smooth, Vascular / physiopathology*
Prognosis
Rupture, Spontaneous
Shear Strength