Evaluating flow modulating treatment response in intracranial aneurysms using black-blood MRI in vitro.

Overview

1. Department of Radiology and Neuroradiology, Section Biomedical Imaging, University Hospital Schleswig-Holstein (UKSH), Kiel University,Kiel, Germany
2. Department of Radiology and Neuroradiology, UKSH, Kiel University,Kiel, Germany
3. Research Campus STIMULATE, University of Magdeburg,Magdeburg, Germany
4. Department of Fluid Dynamics and Technical Flows, University of Magdeburg,Magdeburg, Germany
5. Carle Illinois College of Medicine, University of Illinois Urbana-Champaign,Urbana, IL USA
6. Department of Medical Engineering, University of Magdeburg,Magdeburg, Germany
7. Chair of Inorganic Functional Materials, Kiel University,Kiel, Germany
8. Molecular Imaging North Competence Center (MOIN CC), Kiel, Germany

Abstract

Background: Changes in blood flow after brain aneurysm treatment are linked to treatment success. While 4D flow magnetic resonance imaging (MRI) can measure these changes, it is sensitive to metal artifacts from implants. Black-blood MRI, less affected by artifacts, may complement 4D flow MRI. We investigated whether changes in black-blood signal reflect reductions in blood flow and could indicate the success of aneurysm treatment.

Methods: We performed 22 flow experiments using 3D printed models of two patient-derived brain aneurysms and two straight vessels. Flow-modulating devices, including flow-diverter stents and intrasaccular devices, were inserted into 15 aneurysm models, while untreated models served as controls. All models were imaged with 4D flow and black-blood MRI on a 3 T clinical system. Numerical flow simulations were also performed. Blood flow velocity and black-blood signal were compared between treated and untreated models using non-parametric statistical tests, and their relationship was evaluated with correlation analysis.

Results: Here we show that the black-blood signal in straight vessels decreases with increasing velocity (rho = −0.92, p-value = 3.29E-04). Implanted devices reduce blood flow within aneurysms while leaving flow in the parent vessels essentially unchanged. Treated aneurysms exhibit a significant increase in black-blood signal, which correlates inversely with measured velocity (rho = −0.82, p-value = 6.24E-04). The experimentally observed flow reductions match the numerical simulations. Metal artifacts are more pronounced on 4D flow compared to black-blood MRI.

Conclusions: Black-blood MRI may serve as a surrogate marker of blood flow reduction after aneurysm treatment, particularly in cases where metal artifacts limit conventional imaging.

Reproduced under the paper's license (CC BY), from the paper cited above.

Code

No file of the authors' code could be read here: it is described below, and read at its source.

Code availability

A workflow for MRI data post-processing is publicly available at Zenodo33.

Reproduced under the paper's license (CC BY), from the paper cited above.

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Data

Datasets cited

• zenodo:17183575, at Zenodo; found in the references
• zenodo:17191239, at Zenodo; found in the references

Data availability

The MRI datasets obtained from aneurysm models are available in the Zenodo research repository45,46. Digital aneurysm models of basilar tip aneurysm (BA models) were previously used elsewhere14,34 and are publicly available at Zenodo47. The digital aneurysm model of the internal carotid artery (ICA model) was previously used elsewhere27,48 and available at Zenodo49. CFD data are available from the corresponding author upon reasonable request. The processed data underlying the plots in the figures accompanying this manuscript are available as supplementary data. Namely, the source data for Fig. 4a is in Supplementary Data 1, the source data for Fig. 5 is in Supplementary Data 2, the source data for Fig. 6b is in Supplementary Data 3, the source data for Fig. 6c is in Supplementary Data 4, the source data for Fig. 8a,b and Supplementary Fig. 6a,b is in Supplementary Data 5, the source data for Fig. 8c and Supplementary Fig. 6c is in Supplementary Data 6, the source data for Fig. 10a and Supplementary Fig. 7a is in Supplementary Data 7, the source data for Fig. 10b and Supplementary Fig. 7b is in the Supplementary Data 8, the source data for Supplementary Fig. 3 is in the Supplementary Data 9, the source data for Supplementary Fig. 4 is in the Supplementary Data 10, the source data for Supplementary Fig. 5c is in the Supplementary Data 11.

Reproduced under the paper's license (CC BY), from the paper cited above.

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Version 1, 30 September 2026: the first record

Recorded: type, language, journal, volume, issue, pages, dates, 12 authors, 3 keywords, 3 funders, 48 references.

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This paper

Pravdivtseva, M. S., Toraman, H., Korte, J., Gaidzik, F., Oni, O. A., Berg, P., Velvaluri, P., Bautz, L., Wodarg, F., Hövener, J.-B., Jansen, O., & Larsen, N. (2026). Evaluating flow modulating treatment response in intracranial aneurysms using black-blood MRI in vitro. Communications medicine, 6(1), 170. https://doi.org/10.1038/s43856-026-01413-z

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