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<p>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.</p>

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Investigating Leptomeningeal Anastomoses’ Role in Collateral Blood Flow using SPECT and 4D Flow MRI

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年2月20日

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  • Chi Hang To,
  • Marie Oshima,
  • Shigeki Yamada

摘要

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.