scholarly journals Peri-Aneurysmal Brain Edema in Native and Treated Aneurysms: The Role of Thrombosis

2020 ◽  
Author(s):  
Valeria Onofrj ◽  
Donatella Tampieri ◽  
Alessandro Cianfoni ◽  
Elisa Ventura
Keyword(s):  
Vessel Wall ◽  
Vasogenic Edema ◽  
Cerebral Aneurysms ◽  
Evaluation Process ◽  
Endovascular Embolization ◽  
Vasa Vasorum ◽  
Aneurysm Wall ◽  
Magnetic Resonance Imaging Mri ◽  
Inflammatory Changes

Cerebral peri-aneurysmal edema (PE) is typically associated with giant partially-thrombosed aneurysms and less frequently with smaller aneurysms treated with endovascular embolization. An understanding of the pathophysiologic mechanism of PE is still limited. We report 3 cases of cerebral aneurysms associated with PE. We describe 2 cases of giant partially thrombosed aneurysms surrounded by vasogenic edema with apposition of an intramural and juxtamural thrombus. Our third case is a smaller aneurysm inciting vasogenic edema several years after coil embolization. Vessel-wall magnetic resonance imaging (MRI) showed avid wall enhancement and an enhancing thrombus embedded within the coils, reflecting inflammation of the aneurysm wall and proliferation of the vasa vasorum. Thrombosis within the aneurysmal sac and walls, both in native and treated aneurysms, may promote inflammatory changes and sustain the occurrence of PE. Vessel-wall MRI has a potential role in the evaluation process of this subgroup of aneurysms.

Role of vasa vasorum in transendothelial solute transport in the coronary vessel wall: a study with cryostatic micro-CT

2004 ◽  
Vol 287 (5) ◽  
pp. H2346-H2351 ◽  
Author(s):  
Mario Gössl ◽  
Patricia E. Beighley ◽  
Nasser M. Malyar ◽  
Erik L. Ritman
Keyword(s):  
Coronary Artery ◽  
Surface Area ◽  
Coronary Arteries ◽  
Vessel Wall ◽  
Coronary Vessel ◽  
Vasa Vasorum ◽  
Micro Ct ◽  
Artery Wall ◽  
Coronary Vessel Wall

Using cryostatic microscopic computed tomography (micro-CT), we sought to determine the role of coronary vasa vasorum (VV) in transendothelial solute transport in arteries with normal and increased permeability due to high plasma cholesterol levels. In 6-mo-old pigs on a normal ( n = 23) and 2% high cholesterol (HC) diet ( n = 8), 2-cm segments of the proximal left anterior descending coronary arteries were removed in vivo after a selective injection of X-ray contrast solution. Harvesting of the specimens occurred at 0, 15, 25, 35, or 45 s after completion of the contrast injection. Specimens were snap frozen and scanned in our cryostatic micro-CT. The spatial distribution of contrast in the coronary artery wall was quantified using the CT images. Right coronary arteries were infused with Microfil to determine VV density (VV/mm2) and the cumulative lumen surface area (mm2/mm3). Transendothelial diffusion of contrast into the coronary vessel wall is a dynamic process starting at both the subintima and the adventitia. The subintimal opacification moves as a wave toward the adventitia, whereas the adventitial wave resolves. The coronary vessel wall in animals on a HC diet shows higher opacification than in normal coronary arteries without an increase of VV total luminal surface area. The loss of endothelial integrity in hypercholesterolemia significantly alters VV solute washin to, and washout from, the coronary artery wall.

scholarly journals Wall Enhancement in Evolving Cerebral Aneurysms on Magnetic Resonance Vessel Wall Imaging

Neurosurgery ◽  
2019 ◽  
Vol 66 (Supplement_1) ◽  
Author(s):  
Shunsuke Omodaka ◽  
Hidenori Endo ◽  
Kuniyasu Niizuma ◽  
Miki Fujimura ◽  
Takashi Inoue ◽  
...  
Keyword(s):  
Magnetic Resonance ◽  
Confidence Interval ◽  
Odds Ratio ◽  
Vessel Wall ◽  
Cerebral Aneurysms ◽  
Vessel Wall Imaging ◽  
Unruptured Aneurysms ◽  
Ruptured Aneurysms ◽  
Aneurysm Wall ◽  
Wall Imaging

Abstract INTRODUCTION Recent magnetic resonance (MR) vessel wall imaging studies have indicated cerebral aneurysms in the active state could show wall enhancement along the aneurysm wall (CEAW). While ruptured aneurysms frequently show CEAW, CEAW in the unruptured aneurysms at evolving state, ie growing or symptomatic, has not been studied in detail. We assessed the degree of CEAW in evolving unruptured aneurysms by comparing separately with each of those in stable unruptured aneurysms and ruptured aneurysms. METHODS We performed quantitative analyses of CEAW in consecutive 26 evolving aneurysms using MR vessel wall imaging. Three-dimensional T1-weighted fast spin-echo sequence was obtained before and after contrast media injection, and the contrast ratio of aneurysm wall against the pituitary stalk (CRstalk) was calculated as the indicator of CEAW. We compared aneurysm characteristics of evolving aneurysms with those of 69 stable unruptured and 67 ruptured aneurysms. RESULTS The CRstalk in evolving aneurysms was significantly higher than those in stable aneurysms (0.54 vs 0.34; P < .0001), and lower than those in ruptured aneurysms (0.54 vs 0.83; P < .0002). In multivariable analysis, CRstalk remained significant in comparing evolving with stable aneurysms (odds ratio, 12.23; 95% confidence interval, 3.53-42.41), and with ruptured aneurysms (odds ratio, 0.083; 95% confidence interval, 0.022-0.310). CONCLUSION The CEAW in evolving aneurysms was higher than those in stable aneurysms, and lower than those in ruptured aneurysms.

Hypoxia-induced pulmonary artery adventitial remodeling and neovascularization: contribution of progenitor cells

2004 ◽  
Vol 286 (4) ◽  
pp. L668-L678 ◽  
Author(s):  
Neil J. Davie ◽  
Joseph T. Crossno ◽  
Maria G. Frid ◽  
Stephen E. Hofmeister ◽  
John T. Reeves ◽  
...  
Keyword(s):  
Pulmonary Artery ◽  
Progenitor Cells ◽  
Vessel Wall ◽  
Mononuclear Cells ◽  
Flow Cytometric Analysis ◽  
Vasa Vasorum ◽  
Tyrosine Kinase Receptor ◽  
Wall Thickening ◽  
Factor C

Information is rapidly emerging regarding the important role of the arterial vasa vasorum in a variety of systemic vascular diseases. In addition, increasing evidence suggests that progenitor cells of bone marrow (BM) origin may contribute to postnatal neovascularization and/or vascular wall thickening that is characteristic in some forms of systemic vascular disease. Little is known regarding postnatal vasa formation and the role of BM-derived progenitor cells in the setting of pulmonary hypertension (PH). We sought to determine the effects of chronic hypoxia on the density of vasa vasorum in the pulmonary artery and to evaluate if BM-derived progenitor cells contribute to the increased vessel wall mass in a bovine model of hypoxia-induced PH. Quantitative morphometric analyses of lung tissue from normoxic and hypoxic calves revealed that hypoxia results in a dramatic expansion of the pulmonary artery adventitial vasa vasorum. Flow cytometric analysis demonstrated that cells expressing the transmembrane tyrosine kinase receptor for stem cell factor, c-kit, are mobilized from the BM in the circulation in response to hypoxia. Immunohistochemistry revealed an increase in the expression of c- kit+ cells together with vascular endothelial growth factor, fibronectin, and thrombin in the hypoxia-induced remodeled pulmonary artery vessel wall. Circulating mononuclear cells isolated from neonatal calves exposed to hypoxia were found to differentiate into endothelial and smooth muscle cell phenotypes depending on culture conditions. From these observations, we suggest that the vasa vasorum and circulating progenitor cells could be involved in vessel wall thickening in the setting of hypoxia-induced PH.

scholarly journals Ring enhanced aneurysm due to vasa vasorum of aneurysm wall mimicking a metastatic brain tumor

2021 ◽  
Vol 12 ◽  
pp. 64
Author(s):  
Yu Shimizu ◽  
Katsuyoshi Miyashita ◽  
Nozomu Oikawa ◽  
Masaaki Kobayashi ◽  
Yasuo Tohma
Keyword(s):  
Differential Diagnosis ◽  
Brain Tumor ◽  
Metastatic Brain Tumor ◽  
Vasa Vasorum ◽  
Neurological Deficits ◽  
Peripheral Edema ◽  
Thrombosed Aneurysm ◽  
Aneurysm Wall ◽  
Magnetic Resonance Imaging Mri ◽  
The Right

Background: A spherical intracranial mass can be occasionally misdiagnosed due to the lack of typical radiographic features. Completely thrombosed intracranial aneurysms (CTIA) are uncommon, but a possible differential diagnosis must be considered to guarantee the best surgical approach for these lesions. Case Description: Here, we report an extremely rare case of a right frontal mass mimicking a brain tumor, in which the surgery unveiled a CTIA of the right middle cerebral artery (MCA). A 56-year-old woman presented with right hemiparesis and mild headache. Magnetic resonance imaging (MRI) revealed a right frontal mass with peripheral edema. The lesion enhanced on initial and follow-up MRI of the brain. Subsequent vascular studies and metastatic workup were negative. A temporal craniotomy with neuronavigation (Brain Lab AG, Germany) was performed and an intraoperative diagnosis of a thrombosed aneurysm along the branch of the MCA was established. The aneurysm was successfully trapped and resected. The patient did not exhibit any postoperative neurological deficits. Conclusion: This is the rare report of a ring enhanced completely thrombosed aneurysm due to vasa vasorum which is misdiagnosed as metastatic brain tumor. In case of an intracranial ring enhanced mass with signs of intralesional hemorrhage and peripheral edema, CTIA should be considered as a possible differential diagnosis.

scholarly journals Aneurysm Wall Enhancement in Unruptured Intracranial Aneurysms: A Histopathological Evaluation

2021 ◽  
Author(s):  
Weiying Zhong ◽  
Wenjing Su ◽  
Tao Li ◽  
Xianjun Tan ◽  
Chao Chen ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Vessel Wall ◽  
Inflammatory Cell ◽  
Inflammatory Cell Infiltration ◽  
Vasa Vasorum ◽  
Resonance Imaging ◽  
Intraluminal Thrombus ◽  
Aneurysm Wall ◽  
Microscopic Features

Background Unruptured intracerebral aneurysm wall enhancement (AWE) on vessel wall magnetic resonance imaging scans may be a promising predictor for rupture‐prone intracerebral aneurysms. However, the pathophysiology of AWE remains unclear. To this end, the association between AWE and histopathological changes was assessed in this study. Methods and Results A total of 35 patients with 41 unruptured intracerebral aneurysms who underwent surgical clipping were prospectively enrolled. A total of 27 aneurysms were available for histological evaluation. The macroscopic and microscopic features of unruptured intracerebral aneurysms with and without enhancement were assessed. The microscopic features studied included inflammatory cell invasion and vasa vasorum, which were assessed using immunohistochemical staining with CD68, CD3, CD20, and myeloperoxidase for the former and CD34 for the latter. A total of 21 (51.2%) aneurysms showed AWE (partial AWE, n=7; circumferential AWE, n=14). Atherosclerotic and translucent aneurysms were identified in 17 and 14 aneurysms, respectively. Aneurysm size, irregularity, and atherosclerotic and translucent aneurysms were associated with AWE on univariate analysis ( P <0.05). Multivariate logistic regression analysis showed that atherosclerosis was the only factor significantly and independently associated with AWE ( P =0.027). Histological assessment revealed that inflammatory cell infiltration, intraluminal thrombus, and vasa vasorum were significantly associated with AWE ( P <0.05). Conclusions Though AWE on vessel wall magnetic resonance imaging scans may be associated with the presence of atherosclerotic lesions in unruptured intracerebral aneurysms, inflammatory cell infiltration within atherosclerosis, intraluminal thrombus, and vasa vasorum may be the main pathological features associated with AWE. However, the underlying pathological mechanism for AWE still needs to be further studied.

scholarly journals Association between aneurysm hemodynamics and wall enhancement on 3D vessel wall MRI

2020 ◽  
pp. 1-11 ◽  
Author(s):  
Muhammad Owais Khan ◽  
Veronica Toro Arana ◽  
Christian Rubbert ◽  
Jan F. Cornelius ◽  
Igor Fischer ◽  
...  
Keyword(s):  
Signal Intensity ◽  
Vessel Wall ◽  
Imaging Biomarker ◽  
Shear Stresses ◽  
Hemodynamic Forces ◽  
Cfd Models ◽  
Aneurysm Wall ◽  
Risk Of Rupture ◽  
Computational Fluid Dynamics Cfd

OBJECTIVEAneurysm wall enhancement (AWE) on 3D vessel wall MRI (VWMRI) has been suggested as an imaging biomarker for intracranial aneurysms (IAs) at higher risk of rupture. While computational fluid dynamics (CFD) studies have been used to investigate the association between hemodynamic forces and rupture status of IAs, the role of hemodynamic forces in unruptured IAs with AWE is poorly understood. The authors investigated the role and implications of abnormal hemodynamics related to aneurysm pathophysiology in patients with AWE in unruptured IAs.METHODSTwenty-five patients who had undergone digital subtraction angiography (DSA) and VWMRI studies from September 2016 to September 2017 were included, resulting in 22 patients with 25 IAs, 9 with and 16 without AWE. High-resolution CFD models of hemodynamics were created from DSA images. Univariate and multivariate analyses were performed to investigate the association between AWE and conventional morphological and hemodynamic parameters. Normalized MRI signal intensity was quantified and quantitatively associated with wall shear stresses (WSSs) for the entire aneurysm sac, and in regions of low, intermediate, and high WSS.RESULTSThe AWE group had lower WSS (p < 0.01) and sac-averaged velocity (p < 0.01) and larger aneurysm size (p < 0.001) and size ratio (p = 0.0251) than the non-AWE group. From multivariate analysis of both hemodynamic and morphological factors, only low WSS was found to be independently associated with AWE. Sac-averaged normalized MRI signal intensity correlated with WSS and was significantly different in regions of low WSS compared to regions of intermediate (p = 0.018) and high (p < 0.001) WSS.CONCLUSIONSThe presence of AWE was associated with morphological and hemodynamic factors related to rupture risk. Low WSS was found to be an independent predictor of AWE. Our findings support the hypothesis that low WSS in IAs with AWE may indicate a growth and remodeling process that may predispose such aneurysms to rupture; however, a causality between the two cannot be established.

Role of Cardiac MRI in Detecting Familial Hypertrophic Cardiomyopathy: Review

2016 ◽  
Vol 1 (1) ◽  
pp. 4
Author(s):  
Marymol Koshy ◽  
Bushra Johari ◽  
Mohd Farhan Hamdan ◽  
Mohammad Hanafiah
Keyword(s):  
Hypertrophic Cardiomyopathy ◽  
Magnetic Resonance ◽  
Genetic Disorder ◽  
Familial Hypertrophic Cardiomyopathy ◽  
Non Invasive ◽  
Wide Range ◽  
Proper Diagnosis ◽  
Magnetic Resonance Imaging Mri ◽  
Potential Use

Hypertrophic cardiomyopathy (HCM) is a global disease affecting people of various ethnic origins and both genders. HCM is a genetic disorder with a wide range of symptoms, including the catastrophic presentation of sudden cardiac death. Proper diagnosis and treatment of this disorder can relieve symptoms and prolong life. Non-invasive imaging is essential in diagnosing HCM. We present a review to deliberate the potential use of cardiac magnetic resonance (CMR) imaging in HCM assessment and also identify the risk factors entailed with risk stratification of HCM based on Magnetic Resonance Imaging (MRI).

scholarly journals Morphological and Hemodynamic Changes during Cerebral Aneurysm Growth

2021 ◽  
Vol 11 (4) ◽  
pp. 520
Author(s):  
Emily R. Nordahl ◽  
Susheil Uthamaraj ◽  
Kendall D. Dennis ◽  
Alena Sejkorová ◽  
Aleš Hejčl ◽  
...  
Keyword(s):  
Fluid Dynamics ◽  
Computational Fluid Dynamics ◽  
Kinetic Energy ◽  
Swirling Flow ◽  
Morphological Changes ◽  
Cerebral Aneurysms ◽  
Patient Specific ◽  
Aneurysm Wall ◽  
Aneurysm Growth ◽  
Computational Fluid Dynamics Cfd

Computational fluid dynamics (CFD) has grown as a tool to help understand the hemodynamic properties related to the rupture of cerebral aneurysms. Few of these studies deal specifically with aneurysm growth and most only use a single time instance within the aneurysm growth history. The present retrospective study investigated four patient-specific aneurysms, once at initial diagnosis and then at follow-up, to analyze hemodynamic and morphological changes. Aneurysm geometries were segmented via the medical image processing software Mimics. The geometries were meshed and a computational fluid dynamics (CFD) analysis was performed using ANSYS. Results showed that major geometry bulk growth occurred in areas of low wall shear stress (WSS). Wall shape remodeling near neck impingement regions occurred in areas with large gradients of WSS and oscillatory shear index. This study found that growth occurred in areas where low WSS was accompanied by high velocity gradients between the aneurysm wall and large swirling flow structures. A new finding was that all cases showed an increase in kinetic energy from the first time point to the second, and this change in kinetic energy seems correlated to the change in aneurysm volume.

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