Quantitative and qualitative comparison of 4D-DSA with 3D-DSA using computational fluid dynamics simulations in cerebral aneurysms

Lang S, Birkhold AI, Schmidt M, Endres J, Strother C, Dörfler A, Lücking H, Hölter P (2019)


Publication Type: Journal article

Publication year: 2019

Journal

Book Volume: 40

Pages Range: 1505-1510

Journal Issue: 9

DOI: 10.3174/ajnr.A6172

Abstract

BACKGROUND AND PURPOSE: 4D-DSA allows time-resolved 3D imaging of the cerebral vasculature. The aim of our study was to evaluate this method in comparison with the current criterion standard 3D-DSA by qualitative and quantitative means using computational fluid dynamics. MATERIALS AND METHODS: 3D- and 4D-DSA datasets were acquired in patients with cerebral aneurysms. Computational fluid dynamics analysis was performed for all datasets. Using computational fluid dynamics, we compared 4D-DSA with 3D-DSA in terms of both aneurysmal geometry (quantitative: Maximum diameter, ostium size [OZ1/2], volume) and hemodynamic parameters (qualitative: Flow stability, flow complexity, inflow concentration; quantitative: Average/maximum wall shear stress, impingement zone, low-stress zone, intra-aneurysmal pressure, and flow velocity). Qualitative parameters were descriptively analyzed. Correlation coefficients (r, P value) were calculated for quantitative parameters. RESULTS: 3D- and 4D-DSA datasets of 10 cerebral aneurysms in 10 patients were postprocessed. Evaluation of aneurysmal geometry with 4D-DSA (rmaximum diameter = 0.98, Pmaximum diameter <.001; rOZ1/OZ2 = 0.98/0.86, POZ1/OZ2 =.001/.002; rvolume = 0.98, Pvolume <.001) correlated highly with 3D-DSA. Evaluation of qualitative hemodynamic parameters (flow stability, flow complexity, inflow concentration) did show complete accordance, and evaluation of quantitative hemodynamic parameters (raverage/maximum wall shear stress diastole=0.92/0.88, Paverage/maximum wall shear stress diastole <.001/.001; raverage/maximum wall shear stress systole = 0.94/0.93, Paverage/maximum wall shear stress systole < .001/.001; rimpingement zone=0.96, Pimpingement zone <.001; rlow-stress zone=1.00, Plow-stress zone <.01; rpressure diastole=0.84,Ppressure diastole< .002; rpressure systole=0.9, Ppressure systole <.001; rflow velocity diastole=0.95, Pflow velocity diastole <.001; rflow velocity systole=0.93,Pflow velocity systole <.001) did show nearly complete accordance between 4D- and 3D-DSA. CONCLUSIONS: Despite a different injection protocol, 4D-DSA is a reliable basis for computational fluid dynamics analysis of the intracranial vasculature and provides equivalent visualization of aneurysm geometry compared with 3D-DSA.

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APA:

Lang, S., Birkhold, A.I., Schmidt, M., Endres, J., Strother, C., Dörfler, A.,... Hölter, P. (2019). Quantitative and qualitative comparison of 4D-DSA with 3D-DSA using computational fluid dynamics simulations in cerebral aneurysms. American Journal of Neuroradiology, 40(9), 1505-1510. https://doi.org/10.3174/ajnr.A6172

MLA:

Lang, Sabine, et al. "Quantitative and qualitative comparison of 4D-DSA with 3D-DSA using computational fluid dynamics simulations in cerebral aneurysms." American Journal of Neuroradiology 40.9 (2019): 1505-1510.

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