Prediction of thin-walled areas of unruptured cerebral aneurysms through comparison of normalized hemodynamic parameters and intraoperative images

Abstract

Object. Rupture of a cerebral aneurysm occurs mainly in a thin-walled area (TWA). Prediction of TWAs would help to assess the risk of rupture and select appropriate treatment strategy. There are several limitations of current prediction techniques for TWAs. To predict TWAs more accurately, HP should be normalized to minimize the influence of analysis conditions, and the effectiveness of normalized, combined hemodynamic parameters (CHPs) should be investigated with help of the quantitative color analysis of intraoperative images. Methods. A total of 21 unruptured cerebral aneurysms in 19 patients were analyzed. A normalized CHP was newly suggested as a weighted average of normalized wall shear stress (WSS) and normalized oscillatory shear index (OSI). Delta E from International Commission on Illumination was used to more objectively quantify color differences in intraoperative images. Results. CFD analysis results indicated that WSS and OSI were more predictive of TWAs than pressure (P