Pseudo-Enhancement in Intracranial Aneurysms on Black-Blood MRI: Effects of Flow Rate, Spatial Resolution, and Additional Flow Suppression.
Mariya S. Pravdivtseva1, Franziska Gaidzik2, Philipp Berg2, Carson Hoffman3, Leonardo A. Rivera-Rivera3, Rafael Medero4, Lindsay Bodart3, Alejandro Roldan-Alzate4, Michael A. Speidel3, Kevin M. Johnson3, Oliver Wieben3, Olav Jansen5, Jan-Bernd Hövener1, and Naomi Larsen5
1Section Biomedical Imaging, Molecular Imaging North Competence Center (MOIN CC), Department of Radiology and Neuroradiology, University Medical Center Schleswig-Holstein (UKSH), Kiel University, Kiel, Germany, 2Laboratory of Fluid Dynamics and Technical Flows, Forschungs campus STIMULATE, University of Magdeburg, Magdeburg, Germany, 3Department of Medical Physics and Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI, United States, 4Department of Mechanical Engineering and Radiology, University of Wisconsin School of Medicine and Public Health, Madison, WI, United States, 5Department of Radiology and Neuroradiology, University Medical Center Schleswig-Holstein, Kiel, Germany
An intracranial aneurysm is a life-threatening disease. Vessel-wall enhancement on black-blood MRI was associated with inflammation and proposed as a marker for higher aneurysm rupture risk. However, slow blood flow can mimic wall enhancement. Here, we studied the effects of flow rates, spatial resolution, and motion-sensitized driven equilibrium (MSDE) on black-blood MRI using printed aneurysm models. A hyperintense signal was observed in the models and co-localized with a slow flow. MSDE and higher flow rates reduced the hyperintensities. Slow-flow phenomena contribute substantially to aneurysm enhancement, vary with MRI parameters, and should be considered in rupture assessment.
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