4D-CT angiography versus 3D-rotational angiography as the imaging modality for computational fluid dynamics of cerebral aneurysms
| Autor: | Vitor Mendes Pereira, Olivier Brina, Timo Krings, Karl-Olof Lövblad, Mehdi Najafi, Nicole M. Cancelliere, Pierre Bouillot, Maria Vargas, David A. Steinman |
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| Rok vydání: | 2019 |
| Předmět: |
Male
Computed Tomography Angiography 0206 medical engineering Hemodynamics ddc:500.2 02 engineering and technology Computational fluid dynamics ddc:616.0757 03 medical and health sciences Imaging Three-Dimensional 0302 clinical medicine Aneurysm Blood Flow medicine Humans Four-Dimensional Computed Tomography Modality (human–computer interaction) medicine.diagnostic_test business.industry Endovascular Procedures Angiography Brain Intracranial Aneurysm Computational Fluid Dynamics General Medicine Blood flow Middle Aged medicine.disease 020601 biomedical engineering Cerebral Angiography 3d rotational angiography Rotational angiography Hydrodynamics Female Surgery CT Angiography Neurology (clinical) Nuclear medicine business 030217 neurology & neurosurgery |
| Zdroj: | Journal of NeuroInterventional Surgery, No 015389 (2019) |
| ISSN: | 1759-8486 1759-8478 |
| DOI: | 10.1136/neurintsurg-2019-015389 |
| Popis: | Background and purposeComputational fluid dynamics (CFD) can provide valuable information regarding intracranial hemodynamics. Patient-specific models can be segmented from various imaging modalities, which may influence the geometric output and thus hemodynamic results. This study aims to compare CFD results from aneurysm models segmented from three-dimensional rotational angiography (3D-RA) versus novel four-dimensional CT angiography (4D-CTA).MethodsFourteen patients with 16 cerebral aneurysms underwent novel 4D-CTA followed by 3D-RA. Endoluminal geometries were segmented from each modality using an identical workflow, blinded to the other modality, to produce 28 'original' models. Each was then minimally edited a second time to match length of branches, producing 28 additional 'matched' models. CFD simulations were performed using estimated flow rates for 'original' models (representing real-world experience) and patient-specific flow rates from 4D-CTA for 'matched' models (to control for influence of modality alone).ResultsOverall, geometric and hemodynamic results were consistent between models segmented from 3D-RA and 4D-CTA, with correlations improving after matching to control for operator-introduced variability. Despite smaller 4D-CTA parent artery diameters (3.49±0.97 mm vs 3.78±0.92 mm for 3D-RA; p=0.005) and sac volumes (157 (37–750 mm3) vs 173 (53–770 mm3) for 3D-RA; p=0.0002), sac averages of time-averaged wall shear stress (TAWSS), oscillatory shear (OSI), and high frequency fluctuations (measured by spectral power index, SPI) were well correlated between 3D-RA and 4D-CTA 'matched' control models (TAWSS, R2=0.91; OSI, R2=0.79; SPI, R2=0.90).ConclusionsOur study shows that CFD performed using 4D-CTA models produces reliable geometric and hemodynamic information in the intracranial circulation. 4D-CTA may be considered as a follow-up imaging tool for hemodynamic assessment of cerebral aneurysms. |
| Databáze: | OpenAIRE |
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