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10-20% of patients with subarachnoid hemorrhage die before they arrive at the hospital, and about 25% die within 24 hours. About 1% of patients are diagnosed with cerebral aneurysms in imaging tests for health checkups, and many of them experience aneurysmal rupture during their lifetime, so it is not a rare disease. Wall shear stress is known to be a factor that reflects the state of blood vessels, and particularly plays an important role in the patency of the intima of blood vessels. In the meantime, computed fluid dynamics (CFD), a representative method for calculating wall shear stress, assumes a virtual rigid pipe and applies a preset value. This does not accurately reflect the physiological and dynamic state of the actual blood vessel. The investigators intend to measure the patient's wall shear stress using the SIG of the MRA-TOF technique, which reflects the physiological characteristics of individual patients, and to analyze the association with rupture of the intracranial aneurysm.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Ruptured group | Group of subarachnoid hemorrhage after rupture of intracranial aneurysm |
| |
| Unruptured group | Group of inexperience of aneurysmal rupture during specific period |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Signal intensity gradient | Diagnostic Test | In time-of-flight (TOF) MRA, The signal intensities at the iso-point (Φa; signal intensity at position A [Xa] along the arterial contour line) and at the inner point (Φb; signal intensity at position B [Xb]) were calculated by using a trilinear interpolation algorithm based on the positions and signal intensities in the eight neighboring voxels. The signal intensities of TOF-MRA were normalized to eliminate the offset and scale effects across the MRA datasets of participants. For each iso-point (position A), the SIG was calculated from the difference in signal intensities between points A and B as follows: Scalar SIG, SI/mm = (Φb - Φa) / │Xb - Xa│ (1) Vector SIG, SI/mm = (Φb - Φa) n / │Xb - Xa│ (2) |
| Measure | Description | Time Frame |
|---|---|---|
| Degree of signal intensity gradient in aneurysmal sac | The investigators will measure the degree of signal intensity gradient (SIG) from brain TOF-MRA in aneurysmal sac. The measured SIG in ruptured group would be lower than that in unruptured group. | Average 4-6 years |
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<Ruptured group>
Inclusion Criteria:
1) Patients over 18 years of age who visited our hospital for acute subarachnoid hemorrhage due to rupture of a intracranial aneurysm (2) Among patients satisfying (1), who had intracranial magnetic resonance imaging (time-of-flight (TOF) technique applied; diffusion-weighted imaging, including apparent diffusion coefficient) before subarachnoid hemorrhage occurred.
Exclusion Criteria:
<Unruptured group>
Inclusion Criteria:
Exclusion Criteria:
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Patients visited health checkup program or neurology clinic (unruptured group), or emergency department (ruptured group) of a tertiary center
| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Chan-Hyuk Lee, Dr. | Contact | +82-10-2822-9803 | bluewave0210@gmail.com |
| Name | Affiliation | Role |
|---|---|---|
| Chan-Hyuk Lee, Dr. | Jeonbuk National University Hospital | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Jeonbuk National University Hospital | Recruiting | Jeonju | Jeollabuk-do | 54907 | South Korea |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 28900625 | Background | Han KS, Lee SH, Ryu HU, Park SH, Chung GH, Cho YI, Jeong SK. Direct Assessment of Wall Shear Stress by Signal Intensity Gradient from Time-of-Flight Magnetic Resonance Angiography. Biomed Res Int. 2017;2017:7087086. doi: 10.1155/2017/7087086. Epub 2017 Aug 16. | |
| 30875692 | Background | Suzuki T, Stapleton CJ, Koch MJ, Tanaka K, Fujimura S, Suzuki T, Yanagisawa T, Yamamoto M, Fujii Y, Murayama Y, Patel AB. Decreased wall shear stress at high-pressure areas predicts the rupture point in ruptured intracranial aneurysms. J Neurosurg. 2019 Mar 15;132(4):1116-1122. doi: 10.3171/2018.12.JNS182897. Print 2020 Apr 1. |
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| 31856692 | Background | Lee WJ, Jeong SK, Han KS, Lee SH, Ryu YJ, Sohn CH, Jung KH. Impact of Endothelial Shear Stress on the Bilateral Progression of Unilateral Moyamoya Disease. Stroke. 2020 Mar;51(3):775-783. doi: 10.1161/STROKEAHA.119.028117. Epub 2019 Dec 20. |
| 37696264 | Derived | Lee CH, Kwak HS, Kang HS, Jung KH, Jeong SK. Geometric versus Hemodynamic Indexes for Rupture-Destined Aneurysms: A Retrospective Cohort and a Repeated-Measures Study. Cerebrovasc Dis. 2024;53(3):327-334. doi: 10.1159/000533167. Epub 2023 Sep 11. |