In Vivo Evaluation of Quantitative MR Angiography in a Canine Carotid Artery Stenosis Model

Calderon-Arnulphi, Mateo; Amin‐Hanjani, Sepideh; Alaraj, Ali; Zhao, Ming; Du, Xinjian; Ruland, Sean; Zhang, Xiao; Thulborn, Keith R.; Charbel, Fady T.

doi:10.3174/ajnr.a2546

Cited by 52 publications

(40 citation statements)

References 41 publications

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“…5,[8][9][10][11][12] We found that mean flow dropped on average by 29% after a single embolization session and by 75% at the end of all embolization sessions. Interestingly, the drop in flow per session did not correspond to occlusion of an intranidal fistula or the number of pedicles embolized in that single session, suggesting redistribution of flow through remaining compartments of the nidus in the setting of partial embolization, as posited by Kaspera et al 14 On the other hand, mean flow after completion of all embolization sessions correlated with both the total number of pedicles embolized and embolization of a high-flow fistula, with total pedicles embolized remaining predictive in the multivariate analysis.…”

Section: Discussionmentioning

confidence: 78%

“…The mean number of pedicles embolized per session was 3 (range 1-8) and the mean total number of pedicles embolized was 8 (range [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17] (Table 2). However, the total number of pedicles embolized (R 2 =0.64, P<0.001) and embolization of an intranidal fistula (R 2 =0.40, P=0.002) are each significantly associated with total decreased AVM flow after completion of all sessions of embolization.…”

Section: Predictors Of Decreased Avm Blood Flow After Embolizationmentioning

confidence: 99%

“…This QMRA technique has been validated using in vitro and in vivo models and has demonstrated utility in the hemodynamic evaluation of cerebrovascular pathologies and interventions, including extracranial carotid artery stenosis, intracranial angioplasty/stenting, carotid endarterectomy, and extracranial-intracranial bypass. [8][9][10][11][12] Total AVM blood flow was derived based on the aggregate flow within the primary arterial feeders relative to flow in their contralateral counterparts, according to the following equation: …”

Section: Blood Flow Measurementsmentioning

confidence: 99%

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Quantitative Assessment of Changes in Cerebral Arteriovenous Malformation Hemodynamics After Embolization

Alaraj

Amin‐Hanjani

Aletich

et al. 2015

Stroke

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All sessions of embolization were performed with the liquid embolic agent N-BCA (N-butyl cyanoacrylate; Codman Neurovascular, Inc, Background and Purpose-Embolization reduces flow in arteriovenous malformations (AVMs) before surgical resection, but achievement of this goal is determined subjectively from angiograms. Here, we quantify effects of embolization on AVM flow. Methods-Records of patients who underwent AVM embolization at our institution between 2007 and 2013 and had flow rates obtained pre-and postembolization using quantitative magnetic resonance angiography were retrospectively reviewed. Total flow was estimated as aggregate flow within primary arterial feeders or flow in single draining veins. Results-Twenty-one patients were included (mean age 35 years, 24% hemorrhagic presentation) with Spetzler-Martin grades 1 to 4. Fifty-four total embolization sessions were performed. The mean AVM flow was 403.4±262.4 mL/min at baseline, 285.3±246.4 mL/min after single session (29% drop, P<0.001), and 102.0±103.3 mL/min after all sessions of embolization (75% drop, P<0.001). Total number of pedicles embolized (P<0.001) and embolization of an intranidal fistula during any session (P=0.002) were significantly associated with total decreased flow postembolization. On multivariate analysis, total pedicles embolized was predictive of total flow drop (P<0.001). However, pedicles embolized per session did not correlate with flow drop related to that session (P=0.44). Conclusions-AVM flow changes after embolization can be measured using quantitative magnetic resonance angiography.The total number of pedicles embolized after multiple embolization sessions was predictive of final flow, indicating this parameter is the best angiographic marker of a hemodynamically successful intervention. The number of pedicles embolized per session, however, did not correlate with flow drop in that session, likely because of flow redistribution after partial embolization. (Stroke. 2015;46:942-947.

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Section: Discussionmentioning

confidence: 78%

Section: Predictors Of Decreased Avm Blood Flow After Embolizationmentioning

confidence: 99%

Section: Blood Flow Measurementsmentioning

confidence: 99%

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Quantitative Assessment of Changes in Cerebral Arteriovenous Malformation Hemodynamics After Embolization

Alaraj

Amin‐Hanjani

Aletich

et al. 2015

Stroke

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“…Patients (n = 9) were excluded from data analysis if systolic blood pressure averaged ⩾ 160, leaving a total cohort of 325 patients. published, 11,12 and can be summarized as follows. The major extracranial arteries in the neck were first visualized by two-dimensional MRA time-offlight (TOF) technique (TR/TE, 23 millisecond/4.6 millisecond; flip angle, 60°; FOV, 200 mm; slice thickness, 2 mm; matrix, 256/192; NEX, 1).…”

Section: Materials and Methods Subjectsmentioning

confidence: 99%

“…The accuracy and precision of the protocol used in this study has been published previously. 12 For all subjects, flows in the major intracranial and cervical arteries were measured in standard locations ( Figure 1). These arteries consisted of the left (L) and right (R) common carotid artery, ICA, vertebral artery (VA), proximal middle cerebral artery (MCA), anterior cerebral artery (ACA) proximal pre-communicating segment (A1 segment), posterior cerebral artery (PCA), and BA.…”

Section: Materials and Methods Subjectsmentioning

confidence: 99%

Effect of Age and Vascular Anatomy on Blood Flow in Major Cerebral Vessels

Amin‐Hanjani

Pandey

et al. 2014

J Cereb Blood Flow Metab

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Measurement of volume flow rates in major cerebral vessels can be used to evaluate the hemodynamic effects of cerebrovascular disease. However, both age and vascular anatomy can affect flow rates independent of disease. We prospectively evaluated 325 healthy adult volunteers using phase contrast quantitative magnetic resonance angiography to characterize these effects on cerebral vessel flow rates and establish clinically useful normative reference values. Flows were measured in the major intracranial and extracranial vessels. The cohort ranged from 18 to 84 years old, with 157 (48%) females. All individual vessel flows and total cerebral blood flow (TCBF) declined with age, at 2.6 mL/minute per year for TCBF. Basilar artery (BA) flow was significantly decreased in individuals with one or both fetal posterior cerebral arteries (PCAs). Internal carotid artery flows were significantly higher with a fetal PCA and decreased with a hypoplastic anterior cerebral artery. Indexing vessel flows to TCBF neutralized the age effect, but anatomic variations continued to impact indexed flow in the BA and internal carotid artery. Variability in normative flow ranges were reduced in distal vessels and by examining regional flows. Cerebral vessel flows are affected by age and cerebrovascular anatomy, which has important implications for interpretation of flows in the disease state.

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Magnetic Resonance Imaging Methods for Assessment of Hemodynamic Reserve in Chronic Steno-occlusive Cerebrovascular Disease

Thulborn¹,

McGuire²,

Charbel³

et al. 2021

Cerebrovascular Reactivity

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In Vivo Evaluation of Quantitative MR Angiography in a Canine Carotid Artery Stenosis Model

Cited by 52 publications

References 41 publications

Quantitative Assessment of Changes in Cerebral Arteriovenous Malformation Hemodynamics After Embolization

Quantitative Assessment of Changes in Cerebral Arteriovenous Malformation Hemodynamics After Embolization

Effect of Age and Vascular Anatomy on Blood Flow in Major Cerebral Vessels

Magnetic Resonance Imaging Methods for Assessment of Hemodynamic Reserve in Chronic Steno-occlusive Cerebrovascular Disease

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