White R, Shields A, Nagesh S V, Smith E, Davies J, Bednarek D R, Rudin S, Ionita C, Chivukula V
Biomedical Engineering, Florida Institute of Technology, State University of New York at Buffalo.
Medical Physics, State University of New York at Buffalo.
Proc SPIE Int Soc Opt Eng. 2023 Feb;12468. doi: 10.1117/12.2653871. Epub 2023 Apr 10.
Cerebral aneurysm (CA) rupture is one of the major causes of hemorrhagic stroke. During endovascular therapy (ET), neurointerventionalists rely on qualitative image sequences and do not have access to crucial quantitative hemodynamic information. Quantifying angiographic image sequences can provide vital information, but it is not possible to perform this in a controlled manner in vivo. Computational fluid dynamics (CFD) is a valuable tool capable of providing high fidelity quantitative data by replicating the blood flow physics within the cerebrovasculature. In this work, we use simulated angiograms (SA) to quantify the hemodynamic interaction with a clinically utilized contrast agent. SA enables extraction of time density curves (TDC) within the desired region of interest to analyze hemodynamic parameters such as time to peak (TTP) and mean transit time (MTT) within the aneurysm. We present on the quantification of several hemodynamic parameters of interest for multiple, clinically-relevant scenarios such as variable contrast injection duration and bolus volumes for 7 patient-specific CA geometries. Results indicate that utilizing these analyses provides valuable hemodynamic information relating vascular and aneurysm morphology, contrast flow conditions and injection variability. The injected contrast circulates for multiple cardiac cycles within the aneurysmal region, especially for larger aneurysms and tortuous vasculature. The SA approach enables determination of angiographic parameters for each scenario. Together, these have the potential to overcome the existing barriers in quantifying angiographic procedures in vitro or in vivo, and can provide clinically valuable hemodynamic insights for CA treatment.
脑动脉瘤（CA）破裂是出血性中风的主要原因之一。在血管内治疗（ET）期间，神经介入医生依赖定性图像序列，无法获取关键的定量血流动力学信息。对血管造影图像序列进行量化可以提供重要信息，但在体内以可控方式进行量化是不可能的。计算流体动力学（CFD）是一种有价值的工具，能够通过复制脑血管系统内的血流物理过程来提供高保真定量数据。在这项工作中，我们使用模拟血管造影（SA）来量化与临床使用的造影剂的血流动力学相互作用。SA能够在感兴趣的区域内提取时间密度曲线（TDC），以分析动脉瘤内的血流动力学参数，如峰值时间（TTP）和平均通过时间（MTT）。我们展示了针对多种临床相关场景（如不同的造影剂注射持续时间和团注体积）对7个患者特异性CA几何形状的几个感兴趣的血流动力学参数的量化结果。结果表明，利用这些分析可提供有关血管和动脉瘤形态、造影剂流动条件和注射变异性的有价值的血流动力学信息。注入的造影剂在动脉瘤区域内循环多个心动周期，特别是对于较大的动脉瘤和迂曲的血管系统。SA方法能够确定每种场景下的血管造影参数。这些方法共同有可能克服在体外或体内量化血管造影程序方面存在的障碍，并可为CA治疗提供具有临床价值的血流动力学见解。
