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A Simple Flow Classification Parameter Can Discriminate Rupture Status in Intracranial Aneurysms
Hafez Asgharzadeh1, Ali Shahmohammadi2, Nicole Varble1,3
1Department of Mechanical and Aerospace Engineering, University at Buffalo, Buffalo, New York.
A new aneurysm number (An > 1) can predict intracranial aneurysm rupture status. This simple hemodynamic parameter offers a practical alternative to complex simulations for assessing rupture risk.
Area of Science:
- Biomedical Engineering
- Fluid Dynamics
- Medical Diagnostics
Background:
- A dimensionless aneurysm number (An) differentiates intracranial aneurysm (IA) flow modes: vortex (An > 1) and cavity (An < 1).
- Vortex mode is linked to high oscillatory shear index, a potential rupture indicator.
Purpose of the Study:
- To test the hypothesis that An > 1 can distinguish IA rupture status.
- To evaluate An as a predictor of IA rupture.
Main Methods:
- Retrospective analysis of 204 patient-specific IAs (119 training, 85 testing).
- Calculation of An using pulsatility index (PI) or an optimized PI (PI-hat).
- Statistical analysis using Student's t-test and logistic regression.
Main Results:
- An significantly discriminates ruptured from unruptured IAs (P < .0001).
- An and An-hat accurately predict ruptured IAs, with high AUC values (0.85-0.90) and sensitivity (93-94%) in both training and testing datasets.
- An-hat demonstrated improved specificity (52.85%) in the testing set.
Conclusions:
- An > 1 is a reliable predictor of IA rupture status.
- An offers a simple, practical, and computationally inexpensive alternative to traditional hemodynamic parameters for IA rupture assessment.
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