ArticleAnnals of biomedical engineering2026
Investigating Leptomeningeal Anastomoses' Role in Collateral Blood Flow using SPECT and 4D Flow MRI.
Article in Annals of biomedical engineering, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Leptomeningeal anastomoses (LMAs) are vital components of cerebral collateral circulation, but their small size and inter-patient variability hinder direct quantitative assessment in patient-specific cases. This study investigates the functional role of LMAs and their vessel-level interactions with the cerebral vasculature, using patient-specific flow data and accounting for uncertainty in peripheral vessel anatomy. Synthetic vascular trees were generated via a stochastic, anatomically informed sampling process. Assuming that discrepancies between 4D Flow MRI and Single-Photon Emission Computed Tomography (SPECT) are attributable to LMA-mediated redistribution, LMA configurations were optimized using an island genetic algorithm (IGA) to minimize residuals between simulated distal flows and SPECT-derived perfusion data. The resulting configurations successfully recreated physiologically plausible collateral patterns across four clinical scenarios, encompassing mild to severe, asymmetric, and symptomatic unilateral stenosis.
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