{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,18]],"date-time":"2026-10-18T01:07:54Z","timestamp":1792285674799,"version":"4.4.0"},"reference-count":32,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2025,9,1]],"date-time":"2025-09-01T00:00:00Z","timestamp":1756684800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100020595","name":"National Science and Technology Council","doi-asserted-by":"publisher","award":["NSTC 112\u20102221\u2010E\u2010039\u2010003\u2010MY2"],"award-info":[{"award-number":["NSTC 112\u20102221\u2010E\u2010039\u2010003\u2010MY2"]}],"id":[{"id":"10.13039\/100020595","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100007300","name":"China Medical University","doi-asserted-by":"publisher","award":["CMU113\u2010MF\u201041"],"award-info":[{"award-number":["CMU113\u2010MF\u201041"]}],"id":[{"id":"10.13039\/501100007300","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100007300","name":"China Medical University","doi-asserted-by":"publisher","award":["CMU112\u2010MF\u201054"],"award-info":[{"award-number":["CMU112\u2010MF\u201054"]}],"id":[{"id":"10.13039\/501100007300","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100007300","name":"China Medical University","doi-asserted-by":"publisher","award":["CMU111\u2010MF\u201094"],"award-info":[{"award-number":["CMU111\u2010MF\u201094"]}],"id":[{"id":"10.13039\/501100007300","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["aapm.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Medical Physics"],"published-print":{"date-parts":[[2025,9]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Intracranial aneurysms, particularly saccular types, are localized dilations of cerebral vessels prone to rupture, leading to life\u2010threatening complications such as subarachnoid hemorrhage.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>This study aimed to characterize the localized hemodynamic environment within the aneurysm dome and evaluate how spatial interactions among key flow parameters contribute to rupture risk, using a synergistic analytical framework.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      We applied the targeted evaluation of synergistic links in aneurysms (TESLA) framework to analyze 18 intracranial aneurysms from 15 patients. Patient\u2010specific vascular geometries were reconstructed from high\u2010resolution three\u2010dimensional (3D) time\u2010of\u2010flight magnetic resonance angiography (TOF\u2010MRA), acquired using a 1.5T magnetic resonance imaging (MRI) scanner (MAGNETOM Aera, Siemens Healthineers) with a 20\u2010channel head and neck coil. TOF\u2010MRA employed a gradient\u2010echo sequence leveraging the inflow effect to enhance signal intensity from flowing blood, obviating the need for contrast agents. Imaging parameters were: TR\/TE\u00a0=\u00a024\/7\u00a0ms, flip angle\u00a0=\u00a022\u00b0, field of view (FOV)\u00a0=\u00a0230 \u00d7 200\u00a0mm\n                      <jats:sup>2<\/jats:sup>\n                      , matrix size\u00a0=\u00a0320 \u00d7 196, 100 contiguous slices with a slice thickness of 0.7\u00a0mm, and voxel dimensions\u00a0=\u00a00.72 \u00d7 1.02 \u00d7 0.7\u00a0mm\n                      <jats:sup>3<\/jats:sup>\n                      (acquired) and 0.7 \u00d7 0.7 \u00d7 0.7\u00a0mm\n                      <jats:sup>3<\/jats:sup>\n                      (reconstructed isotropic). Computational fluid dynamics (CFD) simulations were performed to wall shear stress (WSS), time\u2010averaged WSS (TAWSS), oscillatory shear index (OSI), relative residence time (RRT), pressure gradient (PG), and vorticity. A standardized pulsatile inflow waveform (mean flow rate: 275\u00a0mL\u00a0min\n                      <jats:sup>\u22121<\/jats:sup>\n                      ) was applied uniformly at the inlet of each model. Outflow boundary conditions assumed constant pressure at distal locations, with resistance equalization via extension segments. Hemodynamic parameters were compared between ruptured and unruptured aneurysms.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The CFD analysis of 18 intracranial aneurysms revealed marked hemodynamic heterogeneity within the aneurysm dome, with WSS ranging from an average of 0.7042\u00a0Pa in low\u2010stress zones associated with stagnant flow to peaks of 54.0371\u00a0Pa in high\u2010stress regions indicative of mechanical strain, while TAWSS averaged 12.4875\u00a0Pa with maximum values reaching 25.9159\u00a0Pa, highlighting localized stress amplifications. Vorticity averaged 2,422.34 s\n                      <jats:sup>\u22121<\/jats:sup>\n                      with peaks up to 4,645.50 s\n                      <jats:sup>\u22121<\/jats:sup>\n                      , reflecting turbulent and recirculating flow, complemented by an OSI averaging 0.4557 and peaking at 0.4952, and RRT averaging 6.2278\u00a0Pa\n                      <jats:sup>\u22121<\/jats:sup>\n                      , both signifying oscillatory flow and stagnation linked to increased wall vulnerability. Comparative analysis between ruptured and unruptured aneurysms demonstrated markedly higher maximum values of WSS, TAWSS, OSI, PGs, and vorticity (averaging 33,635.322\u00a0Pa\u00a0m\n                      <jats:sup>\u22121<\/jats:sup>\n                      and peaking at 47,390.5\u00a0Pa\u00a0m\n                      <jats:sup>\u22121<\/jats:sup>\n                      ) in ruptured cases, alongside elevated RRT, underscoring the association of extreme hemodynamic disturbances with rupture risk.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The TESLA framework effectively captured localized hemodynamic extremes\u2014elevated stress, oscillatory flow, and prolonged residence time\u2014that were more pronounced in ruptured aneurysms. These findings support TESLA's utility in improving rupture risk assessment and guiding personalized clinical management.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/mp.18071","type":"journal-article","created":{"date-parts":[[2025,9,2]],"date-time":"2025-09-02T05:44:18Z","timestamp":1756791858000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Localized hemodynamic assessment and rupture risk evaluation of intracranial aneurysms using the TESLA framework via computational fluid dynamics"],"prefix":"10.1002","volume":"52","author":[{"given":"Sajid","family":"Ali","sequence":"first","affiliation":[{"name":"Graduate Institute of Biomedical Sciences China Medical University  Taichung Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhen\u2010Ye","family":"Chen","sequence":"additional","affiliation":[{"name":"Graduate Institute of Biomedical Sciences China Medical University  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