ArticleNeuroradiology2026
Associations between middle cerebral artery tortuosity, aneurysm wall enhancement, and hemodynamics assessed by four-dimensional-flow and high-resolution magnetic resonance imaging.
Article in Neuroradiology, 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
purposeParent artery geometry may be associated with the imaging phenotype of intracranial aneurysm. This study aimed to compare ipsilateral and contralateral M1 morphology in patients with unilateral middle cerebral artery (MCA) aneurysms and to explore the associations between parent artery geometry, aneurysm wall enhancement (AWE), and hemodynamic features.
methodsFor this retrospective study, patients with unilateral MCA bifurcation aneurysms from our maintained database were included. All patients underwent four-dimensional (4D)-flow and high-resolution (HR) magnetic resonance imaging (MRI). Parent artery morphology was quantified on standardized bilateral M1 segments, including relative length (RLength) as a tortuosity parameter, calculated as the straight-line distance between centerline endpoints divided by centerline length, and maximum radius (Radius
resultsTwenty-three patients (aged 57 [53.50-64.00]; 26.1% male) were included. The ipsilateral M1 segment showed lower RLength than the contralateral side (0.95 [0.85-0.99] vs. 0.97 [0.94-0.99]; P = 0.035). In exploratory association analyses, higher RLength showed nominal positive correlations with average aneurysm-to-pituitary stalk contrast ratio (CR
conclusionIn MCA bifurcation aneurysms, M1 geometry differed between the aneurysm ipsilateral and contralateral sides. Ipsilateral parent artery geometry showed preliminary exploratory relationships with aneurysm wall enhancement and hemodynamic features, which warrant further validation in larger independent cohorts.
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