Journal of Neuroradiology最新文献

{"title":"Morphological factors and device deformation associated with recurrence in intracranial aneurysms treated with the contour neurovascular system","authors":"Naomi Larsen ,&nbsp;Fritz Wodarg ,&nbsp;Johannes Hensler ,&nbsp;Karim Mostafa ,&nbsp;Sönke Peters ,&nbsp;Mariya Pravdivtseva ,&nbsp;Sylvia Saalfeld ,&nbsp;Friederike Gärtner","doi":"10.1016/j.neurad.2025.101407","DOIUrl":"10.1016/j.neurad.2025.101407","url":null,"abstract":"<div><h3>Background and Purpose</h3><div>The Contour Neurovascular Device is an intrasaccular flow disrupting device designed for the treatment of wide-neck intracranial aneurysms and has been shown to be a safe and effective treatment option. Mid- and long-term results are still scarce, and data on morphological risk factors and device deformation have not been published yet. In this study, we investigate the association of aneurysm-related morphologic parameters and device deformation with recurrence after treatment of intracranial aneurysms with Contour.</div></div><div><h3>Materials and Methods</h3><div>All patients with unruptured and ruptured aneurysms that were treated with Contour in our institution were retrospectively identified. Only patients with 3D-rotational angiography, flat-panel detector-CT or CTA on pre-interventional, 24 h post-interventional, and at least one follow-up imaging were included. Morphological parameters and Contour deformation on longitudinal imaging were tested for an association with aneurysm occlusion status.</div></div><div><h3>Results</h3><div>63 aneurysms were analyzed, the median follow-up time was 17 (range, 2–67) months. Adequate occlusion (BOSS 0–2) on longest follow-up occurred in 79 %, and Contour deformation in 57 %. The parameters neck diameter (<em>p</em> = 0.005, OR 3.1), Contour migration (<em>p</em> = 0.017, OR 9.3) and lateral impression (<em>p</em> = 0.033, OR 5) were significantly and independently associated with deterioration of occlusion status on follow-up imaging. Deformation mostly occurred within a 4 to 6-month follow-up period.</div></div><div><h3>Conclusions</h3><div>Larger neck diameter and Contour deformation are significantly associated with recurrence after treatment with Contour irrespective of the dome-neck ratio. Assessment of Contour deformation on 3D follow-up imaging seems advisable.</div></div>","PeriodicalId":50115,"journal":{"name":"Journal of Neuroradiology","volume":"53 1","pages":"Article 101407"},"PeriodicalIF":3.3,"publicationDate":"2026-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145893409","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tantalum sedimentation in Onyx® syringes: An in-vitro study of agitation strategies to maintain fluoroscopic visibility","authors":"Thibault Agripnidis ,&nbsp;Farouk Tradi ,&nbsp;Quentin Holay ,&nbsp;Alexis Ruimy ,&nbsp;Ahmed-Ali El Ahmadi ,&nbsp;Basile Kerleroux ,&nbsp;Grégoire Boulouis ,&nbsp;Paul Habert ,&nbsp;Mathieu Di Bisceglie ,&nbsp;Sophie Chopinet ,&nbsp;Pauline Brige ,&nbsp;Valentin Espinas ,&nbsp;Samuel Guigo ,&nbsp;Jan-Patrick Stellmann ,&nbsp;Vincent Vidal ,&nbsp;Jean-François Hak","doi":"10.1016/j.neurad.2025.101408","DOIUrl":"10.1016/j.neurad.2025.101408","url":null,"abstract":"<div><h3>Background and purpose</h3><div>During Onyx® plug formation, pauses in injection can lead to tantalum powder sedimentation, reducing fluoroscopic visibility and increasing the risk of reflux and non-target embolization. Syringe agitation is commonly used to counteract this effect. This study aimed to assess sedimentation time and identify the most effective agitation method.</div></div><div><h3>Materials and Methods</h3><div>Standardized preparations of 1 mL syringes were subjected to nine agitation methods (no agitation, automated/manual; fast/slow, rotary/horizontal) at 3, 5, 7, and 10 min. Optical (absorbance, transmittance) and fluoroscopic measurements (visibility, signal-to-noise ratio [SNR]) were performed. A 3D-printed intracranial artery model was also used to assess fluoroscopy visibility.</div></div><div><h3>Results</h3><div>Tantalum sedimentation progressed gradually, with visible deposits after 35.3 ± 7.32 min. Transmittance remained stable for 150 ± 4.12 min before decreasing. All agitation methods significantly improved SNR and visibility versus no agitation. The most effective methods were observed with automatic slow rotary and manual fast rotary agitation, which consistently maintained higher SNR and visibility (<em>p</em> &lt; 0.001). In the 3D model, time had less impact, and rotary agitation did not significantly impact visibility.</div></div><div><h3>Conclusions</h3><div>Agitation during waiting periods is necessary to preserve visibility. Awareness of early fluoroscopy visibility loss is critical — injecting visually opaque but fluoroscopically invisible Onyx® poses procedural risks. During prolonged procedures, preloaded syringes should be regularly agitated to ensure safe embolization.</div></div>","PeriodicalId":50115,"journal":{"name":"Journal of Neuroradiology","volume":"53 1","pages":"Article 101408"},"PeriodicalIF":3.3,"publicationDate":"2026-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145893352","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Does clinical experience still hold any meaning? What remains of clinical experience in the era of Google, AI and ChatGPT?","authors":"Frédéric Clarençon","doi":"10.1016/j.neurad.2025.101413","DOIUrl":"10.1016/j.neurad.2025.101413","url":null,"abstract":"","PeriodicalId":50115,"journal":{"name":"Journal of Neuroradiology","volume":"53 1","pages":"Article 101413"},"PeriodicalIF":3.3,"publicationDate":"2025-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145829063","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ultrasound-guided carotid artery stenting without contrast in ESRD patients","authors":"Ying Tan ,&nbsp;Mingyao Li ,&nbsp;Yujie Che ,&nbsp;Xiaobo Liu ,&nbsp;Jiabao Yang ,&nbsp;Ning Ma","doi":"10.1016/j.neurad.2025.101410","DOIUrl":"10.1016/j.neurad.2025.101410","url":null,"abstract":"","PeriodicalId":50115,"journal":{"name":"Journal of Neuroradiology","volume":"53 1","pages":"Article 101410"},"PeriodicalIF":3.3,"publicationDate":"2025-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145789752","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bias, accuracy, and trust: no GenAI in peer reviewing","authors":"Douraied Ben Salem ,&nbsp;Jean-Alix Barrat ,&nbsp;Samy Ammari ,&nbsp;Sara Lojo Lendoiro ,&nbsp;Ahror Belaid ,&nbsp;Arnaud Attyé ,&nbsp;Mathilde Ducloyer ,&nbsp;Myriam Edjlali Goujon ,&nbsp;Claire Boutet ,&nbsp;Julien Ognard","doi":"10.1016/j.neurad.2025.101411","DOIUrl":"10.1016/j.neurad.2025.101411","url":null,"abstract":"","PeriodicalId":50115,"journal":{"name":"Journal of Neuroradiology","volume":"53 1","pages":"Article 101411"},"PeriodicalIF":3.3,"publicationDate":"2025-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145783650","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Artificial intelligence in the detection of multiple sclerosis plaques: Can it influence the treatment decision?","authors":"Milica Mastilović ,&nbsp;Verónica Muños-Ramírez ,&nbsp;Andreas M. Rauschecker ,&nbsp;Jasmina Boban ,&nbsp;Marie Blanchere ,&nbsp;Francois Cotton ,&nbsp;Olivier Heinzlef ,&nbsp;Myriam Edjlali","doi":"10.1016/j.neurad.2025.101406","DOIUrl":"10.1016/j.neurad.2025.101406","url":null,"abstract":"<div><h3>Background and purpose</h3><div>To monitor multiple sclerosis (MS) progression, follow-up MRIs are used to detect new or enlarging lesions (ELs), typically through manual comparison - a time-consuming, error-prone process. This retrospective study used Pixyl.Neuro.MS®, an AI-based tool, to assess whether AI-assisted readings improve lesion detection and influence treatment decisions.</div></div><div><h3>Materials and Methods</h3><div>The study was conducted retrospectively on MS patients. For the comparison of previous and new MRIs, the deep-learning-based software Pixyl.Neuro.MS® was used. This tool performs lesion segmentation and characterization according to their temporal evolution, facilitating the analysis of new lesions and ELs. Subsequently, a new AI-assisted radiological report was generated and compared with the conventional radiological report. By integrating the AI report with neurological assessments, its potential impact on treatment decisions, in contrast to those based solely on the standard radiological report, was evaluated.</div></div><div><h3>Results</h3><div>In this cohort of 83 MS patients (mean age 49 years, predominantly female), MRI analysis performed by radiologists with AI assistance significantly outperformed standard radiological interpretation. New lesions were identified in 30.1 % of patients using AI-assisted analysis, compared to 14.6 % with conventional reporting (p &lt; 0.001). ELs were detected in 33.7 % of patients through AI-supported evaluation (p &lt; 0.001), while none were identified with standard interpretation. On average, radiologists, aided by AI, identified more new lesions per patient (0.82 vs. 0.46) and achieved a higher true-positive lesion count. Importantly, integrating AI-assisted findings with clinical data led to treatment modification in 10.8 % of patients, underscoring the potential clinical impact of this approach.</div></div><div><h3>Conclusion</h3><div>Artificial intelligence may play a key role in improving detection of new lesions and ELs in patients with MS. The use of Pixyl.Neuro.MS® enhanced radiological interpretation, yielding a more comprehensive assessment of MRI findings compared to conventional analysis. This improved diagnostic precision contributed to revised treatment decisions in a subset of patients.</div></div>","PeriodicalId":50115,"journal":{"name":"Journal of Neuroradiology","volume":"53 1","pages":"Article 101406"},"PeriodicalIF":3.3,"publicationDate":"2025-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145684554","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predicting ventricular volume reduction and overdrainage in idiopathic normal pressure hydrocephalus after ventriculoperitoneal shunt implantation: a radiological study","authors":"Pei-Yu Yeh ,&nbsp;Ue-Cheung Ho ,&nbsp;Hsueh-Yi Lu ,&nbsp;Shih-Hao Huang ,&nbsp;Chi-Ling Chen ,&nbsp;Chien-Chia Chen ,&nbsp;Lu-Ting Kuo","doi":"10.1016/j.neurad.2025.101405","DOIUrl":"10.1016/j.neurad.2025.101405","url":null,"abstract":"<div><h3>Background and purpose</h3><div>Radiological evaluation plays a crucial role in assessing the outcomes of ventriculoperitoneal shunt (VPS) surgery in patients with idiopathic normal pressure hydrocephalus (iNPH). Ventricular volume reduction and overdrainage remain critical concerns after shunt implantation. This study aimed to investigate the radiological changes following VPS surgery and identify predictors of ventricular volume change and overdrainage.</div></div><div><h3>Methods and methods</h3><div>This retrospective study included 75 patients with iNPH who underwent VPS implantation using Medtronic Strata NSC adjustable pressure shunts (initial pressure setting: 1.5). Preoperative and postoperative (3–8 weeks) brain imaging was analyzed to measure ventricular volume changes. Patients were stratified into an overdrainage group (with postoperative subdural effusion) and a non-overdrainage group. Univariate and multivariate analyses were performed to identify factors associated with ventricular volume changes and overdrainage risk.</div></div><div><h3>Results</h3><div>The median preoperative ventricular volume was 100.84 cm³ (IQR: 78.3–130.5 cm³), and the median postoperative volume was 77.57 cm³ (IQR: 55.4–113.4). The median absolute ventricular volume decrease was 19.62 cm³, corresponding to a median percentage reduction of 21.74% (IQR: 4.64–34.87%). Subdural effusion occurred in 18 patients (24.0%), but no subdural hematomas were observed. Multivariate analysis identified older age (<em>p</em> = 0.004) and history of hypertension (<em>p</em> = 0.039) as significant predictors of ventricular volume reduction. Additionally, a greater percentage decrease in ventricular volume (<em>p</em> = 0.005) and absence of hypertension (<em>p</em> = 0.017) were independent risk factors for postoperative subdural effusion.</div></div><div><h3>Conclusions</h3><div>Ventricular volume reduction following VPS surgery in iNPH is significantly associated with patient age and hypertension history. Overdrainage risk correlates with greater ventricular volume reduction and the absence of hypertension. These findings provide valuable radiological insights for optimizing shunt pressure settings and minimizing complications in iNPH patients undergoing VPS surgery.</div></div>","PeriodicalId":50115,"journal":{"name":"Journal of Neuroradiology","volume":"53 1","pages":"Article 101405"},"PeriodicalIF":3.3,"publicationDate":"2025-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145490632","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessment of glymphatic dysfunction in ulcerative colitis using DKI-ALPS: An innovative imaging biomarker","authors":"Cuiping Bao ,&nbsp;Yue Ma ,&nbsp;Muran Li ,&nbsp;Yiming Li ,&nbsp;Chunze Zhang ,&nbsp;Xuehuan Liu ,&nbsp;Ran Fan ,&nbsp;Weiwei Cui ,&nbsp;Xiaomeng Fan ,&nbsp;Feifei Zheng ,&nbsp;Feng Duan ,&nbsp;Jun Liu","doi":"10.1016/j.neurad.2025.101402","DOIUrl":"10.1016/j.neurad.2025.101402","url":null,"abstract":"<div><h3>Purpose</h3><div>Ulcerative colitis (UC) is associated with higher anxiety, depression, and cognitive disorders linked to brain glymphatic dysfunction. In this study, we used along-the-perivascular-space (ALPS) index (based on DTI and DKI) to determine if UC relates to glymphatic dysfunction and explore how microbiota dysbiosis and inflammation affect brain glymphatic function.</div></div><div><h3>Materials and Methods</h3><div>In this study, 63 patients with UC and 68 healthy controls underwent 3-Tesla MRI scans to evaluate DTI-ALPS and DKI-ALPS index. The protocol included diffusion-weighted imaging (DWI) and diffusion kurtosis imaging (DKI) sequences to calculate the ALPS index, which quantifies glymphatic system function. All participants completed cognitive (MMSE) and depression (SAS/SDS) assessments (SAS/SDS). Patients with UC also underwent assessment for inflammation and gut microbiota (based on metagenomic analysis). Data analysis was performed using correlation analysis and linear regression.</div></div><div><h3>Results</h3><div>Patients with UC showed lower DTI-ALPS index (1.25) and DKI-ALPS index (1.40) compared to controls (1.40 vs. 1.69; <em>P</em> &lt; 0.001). In multi-adjusted linear regression models, UC was associated with lower DTI-ALPS index and DKI-ALPS index (β =-0.142 vs.-0.284), with DKI-ALPS showing higher sensitivity. The results remained significant even after stratification by age and sex. The Mayo score correlated negatively with DTI and DKI-ALPS index. The ALPS index correlates with gut microbiota, particularly those involved in butyrate and short-chain fatty acid (SCFA) production. DTI-ALPS index was significantly correlated with ESR (β =-0.003), CRP (β =-0.035), SII (β =-0.062), INFLA (β =-0.010), and SIRI (β =-0.058). We also observed significant correlations between DKI ALPS index and ESR (β =-0.006), CRP (β =-0.051), SII (β =-0.130), INFLA (β =-0.017), SIRI (β =-0.095), IL-6 (β =-0.081) and NLR (β =-0.108).</div></div><div><h3>Conclusions</h3><div>UC is associated with brain glymphatic dysfunction, correlating with inflammation level. DKI-ALPS serves as a more sensitive method than DTI-ALPS, offering a new approach for managing ulcerative colitis through glymphatic dysfunction.</div></div>","PeriodicalId":50115,"journal":{"name":"Journal of Neuroradiology","volume":"53 1","pages":"Article 101402"},"PeriodicalIF":3.3,"publicationDate":"2025-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145467145","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The rabbit superior mesenteric artery as an in vivo model for perforator artery occlusion assessment after flow diversion","authors":"Jonathan Cortese ,&nbsp;Esref A Bayraktar ,&nbsp;Julien Ognard ,&nbsp;Daying Dai ,&nbsp;Armin Zarrintan ,&nbsp;Sherief Ghozy ,&nbsp;Sarah Lortscher ,&nbsp;Yong Hong Ding ,&nbsp;Juan R Cebral ,&nbsp;Waleed Brinjikji ,&nbsp;David F Kallmes ,&nbsp;Ramanathan Kadirvel","doi":"10.1016/j.neurad.2025.101404","DOIUrl":"10.1016/j.neurad.2025.101404","url":null,"abstract":"<div><h3>Objective</h3><div>Covering side branches with flow diverters (FDs) raises concerns regarding side branch occlusion and potentially delayed ischemic complications. Existing preclinical models fail to replicate these risks. We developed a novel preclinical model using the rabbit superior mesenteric artery (SMA) to investigate FD-associated branch occlusion and neointimal changes.</div></div><div><h3>Material and methods</h3><div>Eighteen rabbits were enrolled; three were excluded for periprocedural complications. Fifteen animals completed follow-up, each with a single FD implanted in the SMA (one of three Pipeline Embolization Devices: 5 Bare-Flex, 4 Shield-Flex, and 6 Vantage). Branch patency (using Digital subtraction angiography DSA and histology) and ostial coverage/neointima (using optical coherence tomography OCT), were assessed at 1 or 3 months. Results were compared between-(FD and time) groups using Mann-Whitney and Kruskal-Wallis test.</div></div><div><h3>Results</h3><div>Fifteen animals completed the study. Among 35 covered branches, 30 (85.7%) remained patent, 4 (11.4%) were pre-occlusive, and 1 (2.9%) occluded. Median ostium coverage by OCT was 77.0%. Mean in-stent stenosis was 35.0%. No significant difference were found across FD types or timepoints comparing patency, medium ostium coverage, in-stent stenosis. Histology confirmed progressive neointimal maturation and partial to full ostium coverage, with strong correlation to OCT findings. No correlation was found between neointimal thickness and ostium coverage.</div></div><div><h3>Conclusion</h3><div>The rabbit SMA model successfully detected rare occlusions and common pre-occlusive changes, approaching clinical data. This model may help to evaluate FD safety, optimize design, and investigate endothelial responses.</div></div>","PeriodicalId":50115,"journal":{"name":"Journal of Neuroradiology","volume":"53 1","pages":"Article 101404"},"PeriodicalIF":3.3,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145439799","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Computational fluid dynamics analysis of blood blister aneurysms: A comparative study with normal supraclinoid internal carotid arteries","authors":"Te-Chang Wu ,&nbsp;Zhen-Ye Chen ,&nbsp;Yi-Lin Wu ,&nbsp;Tzu-Ching Shih","doi":"10.1016/j.neurad.2025.101403","DOIUrl":"10.1016/j.neurad.2025.101403","url":null,"abstract":"<div><h3>Background and Purpose</h3><div>The purpose of this study was to evaluate hemodynamic differences between blood blister aneurysms (BBAs) and normal supraclinoid internal carotid arteries (ICAs) using patient-specific vascular models.</div></div><div><h3>Materials and Methods</h3><div>Thirteen models of ruptured BBA and 13 models of normal ICA were constructed from the petrous ICA proximally to M1 and A1 segments distally via 3D rotational angiography or MR angiography. Computational fluid dynamics (CFD) simulation was employed to calculate hemodynamic parameters, including time-average wall shear stress (TAWSS), wall shear stress gradient (WSSG), pressure difference (PD), oscillatory shear index (OSI), and relative residence time (RRT). Mann-Whitney U Test was used to identify differences between BBA and normal ICAs</div></div><div><h3>Results</h3><div>Compared with normal ICAs, BBAs exhibited significantly higher OSI (average and maximum: 0.0097/ 0.22 vs 0.0035/ 0.0135, <em>p</em> &lt; 0.01), higher RRT (average and maximum: 0.60/ 8.50 vs 0.28/ 0.54, <em>p</em> = 0.018 &amp; &lt; 0.01), higher maximum WSSG (20,492 vs 9208, <em>p</em> = 0.012), higher maximum PD (1.34 vs 0.89, <em>p</em> = 0.027) and lower minimum TAWSS (0.35,Pa vs 2.55,Pa, <em>P</em> &lt; 0.01). A swirling TAWSS pattern was identified in three of the four BBAs with early rebleeding post-treatment and in the two cases with in-hospital mortality.</div></div><div><h3>Conclusions</h3><div>BBAs demonstrated low and multi-directional wall shear stress on the aneurysmal wall with higher OSI and RRT compared to normal ICAs. A swirling pattern in the TAWSS map was identified as a poor prognostic factor. The findings support CFD as a promising tool for assessing rupture risk and guiding clinical decisions of BBAs.</div></div>","PeriodicalId":50115,"journal":{"name":"Journal of Neuroradiology","volume":"53 1","pages":"Article 101403"},"PeriodicalIF":3.3,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145432869","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}