Improved visualization of the intracranial aneurysm wall with advanced black-blood Magnetic Resonance Imaging

• Applicant: Dr. Marie Teresa Nawka
• Subject Area: Clinical Neurology; Neurosurgery and Neuroradiology ; Radiology
• Term: since 2022
• Project identifier: Deutsche Forschungsgemeinschaft (DFG) - Project number 506191426

An intracranial aneurysm is a cerebrovascular disorder which leads to a weakness in the wall of a cerebral artery, thus causing a localized dilatation or ballooning of the blood vessel. With a prevalence between 2-4% in the general population, intracranial aneurysms are a relatively common finding. Because the architecture of intracranial aneurysms is different from healthy blood vessels, aneurysms are prone to rupture, resulting in subarachnoid hemorrhage. The probability of aneurysm rupture is estimated to be around 5% within 5 years. Subarachnoid hemorrhage is a dreaded and devastating type of brain hemorrhage with a high mortality rate of around 40%. It results in enormous costs for the healthcare system, thus, not merely aneurysm treatment but early and timely diagnosis are indispensable. Conventional treatment options for intracranial aneurysms are either neurosurgical or endovascular. The shape and location of the aneurysm determine which treatment is appropriate, but endovascular therapy is currently the favorable treatment approach. Unfortunately, aneurysms can recur after treatment and therefore, regular follow-up examinations are mandatory. To identify and determine the anatomic conditions of an intracranial aneurysm, a broad range of diagnostic methods is available. Digital subtraction angiography is an invasive technique which particularly depicts the aneurysm anatomy, but the method is not able to provide detailed information about the integrity of the vessel wall. Magnetic Resonance Imaging (MRI) is a widely available and attractive alternative, because it is less invasive and doesn’t require ionizing radiation. Different MRI techniques offer the opportunity to visualize intracranial aneurysms, including contrast-agent based angiography and non-contrast enhanced angiography. Black blood imaging is a specific noninvasive MRI technique which saturates the blood flow and thus enables the evaluation of the aneurysm wall itself. However, various artifacts accompanying this method sometimes impede the correct diagnosis and potentially harmful inflammatory processes within the vessel wall or decreasing stability of the aneurysm might be missed. To overcome these limitations, we aimed to develop a novel MRI sequence combining the black blood imaging method with the dynamic flow acquisition technique. With the establishment of this new MRI sequence into clinical routine (follow-up) imaging, the assessment of treated and untreated intracranial aneurysms will be uniquely facilitated and potential complications arising from this pathology will be significantly minimized.

• DFG Programme: Research Grants
• International Connection: Canada
• Co-Investigators: Professor Dr. Jens Fiehler; Dr. Thomas Lindner
• Cooperation Partner: Professor Dr. Nils Daniel Forkert