Morphological and hemodynamic differences between aneurysmal middle cerebral artery bifurcation and contralateral nonaneurysmal anatomy

Jianping Song, Fengping Zhu, Yi Qian, Chubin Ou, Jiajun Cai, Xiang Zou, Zehan Wu, Wei Zhu, Liang Chen*, Ying Mao

*Corresponding author for this work

    Research output: Contribution to journalArticlepeer-review

    13 Citations (Scopus)

    Abstract

    BACKGROUND: The morphological and hemodynamic features differ between middle cerebral artery (MCA) bifurcations with and without aneurysms.

    OBJECTIVE: To investigate the morphological and hemodynamic differences between aneurysmal MCA bifurcation and contralateral nonaneurysmal anatomy.

    METHODS: Computed tomography angiography of 36 patients with unilateral small saccular MCA bifurcation aneurysms was evaluated. The parent-daughter angles (φ1 for larger branch and φ2 for smaller branch), bifurcation angle (φ = φ1 + φ2), inclination angle (γ angle), and their relationships with the MCA bifurcation locations were analyzed. Computational fluid dynamics simulation was performed in 6 cases to explore the hemodynamics influenced by the bifurcation morphology.

    RESULTS: The φ angle was significantly higher in aneurysmal than contralateral nonaneurysmal bifurcations (160.8° ± 31.0° vs 99.0° ± 19.2°, respectively; P = .000); the φ1, φ2, and γ angles were also higher. However, by regression analysis combined with MCA bifurcation locations, only the φ angle might be associated with the aneurysm presence (odds ratio = 1.120, 95% confidence interval = 1.059-1.185) and a φ angle cut-off of 124.8° was established. Computational fluid dynamics simulation demonstrated that flow resistance of the wider aneurysmal MCA bifurcation was significantly higher than that on the contralateral side.

    CONCLUSION: A larger φ angle was more prevalent in aneurysmal than nonaneurysmal MCA bifurcations, and the higher flow resistance caused by the larger φ angle might be a potential hemodynamic factor associated with MCA aneurysm presence.

    Original languageEnglish
    Pages (from-to)779-786
    Number of pages8
    JournalNeurosurgery
    Volume81
    Issue number5
    DOIs
    Publication statusPublished - 1 Nov 2017

    Keywords

    • computational fluid dynamics
    • computed tomography angiography
    • intracranial aneurysm
    • middle cerebral artery
    • morphology
    • Computed tomography angiography
    • Computational fluid dynamics
    • Intracranial aneurysm
    • Morphology
    • Middle cerebral artery

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