Emerging Techniques for Evaluation of the Hemodynamics of Intracranial Vascular Pathology

• Published in: The Neuroradiology Journal Vol. 28; no. 1; pp. 18 - 27
• Main Authors: Chang, Warren, Huang, Melissa, Chien, Aichi
• Format: Book Review Journal Article
• Language: English
• Published: London, England SAGE Publications 01-02-2015
• Subjects: Angiography, Digital Subtraction; Brain Ischemia - diagnosis; Central Nervous System Vascular Malformations - diagnosis; Cerebral Angiography; Cerebrovascular Circulation; Four-Dimensional Computed Tomography; Hemodynamics; Humans; Intracranial Aneurysm - diagnosis; Intracranial Hemorrhages - diagnosis; Magnetic Resonance Angiography; Review; Stroke - diagnosis; intracranial hemorrhage; computational fluid dynamics; arteriovenous malformations; stenoses; magnetic resonance angiography; stroke; hemodynamics; flow; aneurysms
• ISSN: 1971-4009; 2385-1996
• DOI: 10.15274/nrj-2014-10115

Advances in imaging modalities have improved the assessment of intracranial hemodynamics using non-invasive techniques. This review examines new imaging modalities and clinical applications of currently available techniques, describes pathophysiology and future directions in hemodynamic analysis of intracranial stenoses, aneurysms and arteriovenous malformations and explores how hemodynamic analysis may have prognostic value in predicting clinical outcomes and assist in risk stratification. The advent of new technologies such as pseudocontinuous arterial spin labeling, accelerated magnetic resonance angiography (MRA) techniques, 4D digital subtraction angiography, and improvements in clinically available techniques such as phase-contrast MRA may change the landscape of vascular imaging and modify current clinical practice guidelines.