4D-CT angiography versus 3D-rotational angiography as the imaging modality for computational fluid dynamics of cerebral aneurysms

2019 ◽  
Vol 12 (6) ◽  
pp. 626-630 ◽  
Author(s):  
Nicole M Cancelliere ◽  
Mehdi Najafi ◽  
Olivier Brina ◽  
Pierre Bouillot ◽  
Maria I Vargas ◽  
...  
Keyword(s):  
Fluid Dynamics ◽  
Computational Fluid Dynamics ◽  
Ct Angiography ◽  
Cerebral Aneurysms ◽  
Patient Specific ◽  
Parent Artery ◽  
Rotational Angiography ◽  
Specific Flow ◽  
Flow Rates ◽  
Hemodynamic Assessment

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.

scholarly journals Morphological and Hemodynamic Changes during Cerebral Aneurysm Growth

2021 ◽  
Vol 11 (4) ◽  
pp. 520
Author(s):  
Emily R. Nordahl ◽  
Susheil Uthamaraj ◽  
Kendall D. Dennis ◽  
Alena Sejkorová ◽  
Aleš Hejčl ◽  
...  
Keyword(s):  
Fluid Dynamics ◽  
Computational Fluid Dynamics ◽  
Kinetic Energy ◽  
Swirling Flow ◽  
Morphological Changes ◽  
Cerebral Aneurysms ◽  
Patient Specific ◽  
Aneurysm Wall ◽  
Aneurysm Growth ◽  
Computational Fluid Dynamics Cfd

Computational fluid dynamics (CFD) has grown as a tool to help understand the hemodynamic properties related to the rupture of cerebral aneurysms. Few of these studies deal specifically with aneurysm growth and most only use a single time instance within the aneurysm growth history. The present retrospective study investigated four patient-specific aneurysms, once at initial diagnosis and then at follow-up, to analyze hemodynamic and morphological changes. Aneurysm geometries were segmented via the medical image processing software Mimics. The geometries were meshed and a computational fluid dynamics (CFD) analysis was performed using ANSYS. Results showed that major geometry bulk growth occurred in areas of low wall shear stress (WSS). Wall shape remodeling near neck impingement regions occurred in areas with large gradients of WSS and oscillatory shear index. This study found that growth occurred in areas where low WSS was accompanied by high velocity gradients between the aneurysm wall and large swirling flow structures. A new finding was that all cases showed an increase in kinetic energy from the first time point to the second, and this change in kinetic energy seems correlated to the change in aneurysm volume.

WHICH MORPHOLOGIC AND HEMODYNAMIC CHARACTERISTICS PREDICT INTRACRANIAL FUSIFORM ANEURYSMS RUPTURE? A PATIENT-SPECIFIC COMPUTATIONAL FLUID DYNAMICS STUDY

2017 ◽  
Vol 17 (03) ◽  
pp. 1750070
Author(s):  
YAN CHEN ◽  
YI-BIN FANG ◽  
PENG-FEI YANG ◽  
QING-HAI HUANG ◽  
JIAN-MIN LIU
Keyword(s):  
Fluid Dynamics ◽  
Computational Fluid Dynamics ◽  
Cfd Simulation ◽  
Patient Specific ◽  
Parent Artery ◽  
Cross Sectional ◽  
3D Angiography ◽  
Cross Section Area ◽  
Increased Risk ◽  
Risk Of Rupture

To identify hemodynamic and morphological parameters leading to increased risk of intracranial fusiform aneurysms (IFA) rupture using computational fluid dynamics (CFDs). A total of 24 patient-specific fusiform aneurysms models on vertebral artery were reconstructed from 3D angiography images. 11 ruptured cases and 13 unruptured cases were included. Morphologic parameters were measured and CFD parameters were calculated using CFD simulation. The length of the aneurysm is significantly shorter in ruptured group than in unruptured group. The ratio of the width to the length of an aneurysm (WLR) and the ratio of the cross-section area to the length of an aneurysm (ALR) to the averaged cross sectional areas of the inlet and outlet of the parent artery (ALaR) were significantly higher in ruptured group compared with unruptured group. Wall shear stress (WSS) of the aneurysm was normalized to the WSS of the parent artery. Hemodynamically, only low WSS was associated with higher risk of rupture. Ruptured IFAs are shorter, have bigger WLR, ALaR, and lower WSS, compared with unruptured IFAs.

scholarly journals Computational Fluid Dynamics for Cerebral Aneurysms in Clinical Settings

2021 ◽  
pp. 27-32
Author(s):  
Fujimaro Ishida ◽  
Masanori Tsuji ◽  
Satoru Tanioka ◽  
Katsuhiro Tanaka ◽  
Shinichi Yoshimura ◽  
...  
Keyword(s):  
Fluid Dynamics ◽  
Computational Fluid Dynamics ◽  
Cerebral Aneurysms ◽  
Patient Specific ◽  
Clinical Settings ◽  
Geometry Model ◽  
Aneurysm Wall ◽  
3D Ct Angiography ◽  
Specific Geometry ◽  
Computational Fluid Dynamics Cfd

AbstractHemodynamics is thought to play an important role in the pathogenesis of cerebral aneurysms and recent development of computer technology makes it possible to simulate blood flow using high-resolution 3D images within several hours. A lot of studies of computational fluid dynamics (CFD) for cerebral aneurysms were reported; therefore, application of CFD for cerebral aneurysms in clinical settings is reviewed in this article.CFD for cerebral aneurysms using a patient-specific geometry model was first reported in 2003 and it has been revealing that hemodynamics brings a certain contribution to understanding aneurysm pathology, including initiation, growth and rupture. Based on the knowledge of the state-of-the-art techniques, this review treats the decision-making process for using CFD in several clinical settings. We introduce our CFD procedure using digital imaging and communication in medicine (DICOM) datasets of 3D CT angiography or 3D rotational angiography. In addition, we review rupture status, hyperplastic remodeling of aneurysm wall, and recurrence of coiled aneurysms using the hemodynamic parameters such as wall shear stress (WSS), oscillatory shear index (OSI), aneurysmal inflow rate coefficient (AIRC), and residual flow volume (RFV).

scholarly journals Effect of Inlet Velocity Profiles on Patient-Specific Computational Fluid Dynamics Simulations of the Carotid Bifurcation

2012 ◽  
Vol 134 (5) ◽  
Author(s):  
Ian C. Campbell ◽  
Jared Ries ◽  
Saurabh S. Dhawan ◽  
Arshed A. Quyyumi ◽  
W. Robert Taylor ◽  
...  
Keyword(s):  
Fluid Dynamics ◽  
Computational Fluid Dynamics ◽  
Velocity Profile ◽  
Carotid Bifurcation ◽  
Velocity Profiles ◽  
Patient Specific ◽  
Flow Waveform ◽  
Specific Flow ◽  
Inlet Velocity ◽  
The Mean

Patient-specific computational fluid dynamics (CFD) is a powerful tool for researching the role of blood flow in disease processes. Modern clinical imaging technology such as MRI and CT can provide high resolution information about vessel geometry, but in many situations, patient-specific inlet velocity information is not available. In these situations, a simplified velocity profile must be selected. We studied how idealized inlet velocity profiles (blunt, parabolic, and Womersley flow) affect patient-specific CFD results when compared to simulations employing a “reference standard” of the patient’s own measured velocity profile in the carotid bifurcation. To place the magnitude of these effects in context, we also investigated the effect of geometry and the use of subject-specific flow waveform on the CFD results. We quantified these differences by examining the pointwise percent error of the mean wall shear stress (WSS) and the oscillatory shear index (OSI) and by computing the intra-class correlation coefficient (ICC) between axial profiles of the mean WSS and OSI in the internal carotid artery bulb. The parabolic inlet velocity profile produced the most similar mean WSS and OSI to simulations employing the real patient-specific inlet velocity profile. However, anatomic variation in vessel geometry and the use of a nonpatient-specific flow waveform both affected the WSS and OSI results more than did the choice of inlet velocity profile. Although careful selection of boundary conditions is essential for all CFD analysis, accurate patient-specific geometry reconstruction and measurement of vessel flow rate waveform are more important than the choice of velocity profile. A parabolic velocity profile provided results most similar to the patient-specific velocity profile.

scholarly journals Hemodynamic Effect of Unequal Anterior Cerebral Artery Flow Rates on the Anterior Communicating Artery Bifurcation: A Computational Fluid Dynamics Study

2008 ◽  
Vol 2008 ◽  
pp. 1-9 ◽  
Author(s):  
Thomas Rau ◽  
Xing He ◽  
Prem Venugopal ◽  
Fernando Viñuela ◽  
Gary Duckwiler ◽  
...  
Keyword(s):  
Fluid Dynamics ◽  
Computational Fluid Dynamics ◽  
Cerebral Artery ◽  
Anterior Cerebral Artery ◽  
Hemodynamic Effect ◽  
Anterior Communicating Artery ◽  
Parent Artery ◽  
Symmetric Model ◽  
Flow Rates ◽  
Artery Flow

Computational fluid dynamics techniques were used to investigate the hemodynamic effect of unequal anterior cerebral artery flow rates on the anterior cerebral and anterior communicating artery (ACA-ACOM) bifurcation. Hemodynamics have long been implicated as a major factor in cerebrovascular disease. Using an idealized 2D symmetric model of the ACA-ACOM geometry, the flow field and wall shear stress (WSS) at the bifurcation regions are assessed for pulsatile inflows with left to right flow ratios of 1:1, 2:1, 3:1, and 4:1. Unequal flow rates through the ACA parent arteries result in bifurcation of the higher flow parent stream and a shifting of the impingement points along the A2-ACOM adjoining wall toward the contralateral ACA. Cross-flow through the ACOM is generally unstable and results in increased WSS at the impingement region from the higher flow parent artery and a double amplitude peak in the WSS at the contralateral bifurcation region from local recirculation effects. These results suggest that asymmetry in ACA flow rates result in increased hemodynamic stresses at the ACA-ACOM bifurcation regions and suggest a possible factor for vessel weakening and aneurysm formation.

How patient-specific do internal carotid artery inflow rates need to be for computational fluid dynamics of cerebral aneurysms?

2020 ◽  
pp. neurintsurg-2020-015993 ◽  
Author(s):  
Mehdi Najafi ◽  
Nicole M Cancelliere ◽  
Olivier Brina ◽  
Pierre Bouillot ◽  
Maria I Vargas ◽  
...  
Keyword(s):  
Fluid Dynamics ◽  
Computational Fluid Dynamics ◽  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Internal Carotid ◽  
Spectral Power ◽  
Cerebral Aneurysms ◽  
Patient Specific ◽  
Perfect Agreement ◽  
The Impact

BackgroundComputational fluid dynamics (CFD) has become a popular tool for studying ‘patient-specific’ blood flow dynamics in cerebral aneurysms; however, rarely are the inflow boundary conditions patient-specific. We aimed to test the impact of widespread reliance on generalized inflow rates.MethodsInternal carotid artery (ICA) flow rates were measured via 2D cine phase-contrast MRI for 24 patients scheduled for endovascular therapy of an ICA aneurysm. CFD models were constructed from 3D rotational angiography, and pulsatile inflow rates imposed as measured by MRI or estimated using an average older-adult ICA flow waveform shape scaled by a cycle-average flow rate (Qavg) derived from the patient’s ICA cross-sectional area via an assumed inlet velocity.ResultsThere was good overall qualitative agreement in the magnitudes and spatial distributions of time-averaged wall shear stress (TAWSS), oscillatory shear index (OSI), and spectral power index (SPI) using generalized versus patient-specific inflows. Sac-averaged quantities showed moderate to good correlations: R2=0.54 (TAWSS), 0.80 (OSI), and 0.68 (SPI). Using patient-specific Qavg to scale the generalized waveform shape resulted in near-perfect agreement for TAWSS, and reduced bias, but not scatter, for SPI. Patient-specific waveform had an impact only on OSI correlations, which improved to R2=0.93.ConclusionsAneurysm CFD demonstrates the ability to stratify cases by nominal hemodynamic ‘risk’ factors when employing an age- and vascular-territory-specific recipe for generalized inflow rates. Qavg has a greater influence than waveform shape, suggesting some improvement could be achieved by including measurement of patient-specific Qavg into aneurysm imaging protocols.

scholarly journals Computational fluid dynamics evaluation of flow reversal treatment of giant basilar tip aneurysm

2015 ◽  
Vol 21 (5) ◽  
pp. 586-591 ◽  
Author(s):  
Martin Sandve Alnæs ◽  
Kent-Andre Mardal ◽  
Søren Bakke ◽  
Angelika Sorteberg
Keyword(s):  
Fluid Dynamics ◽  
Computational Fluid Dynamics ◽  
Shear Stress ◽  
Wall Shear Stress ◽  
Flow Reversal ◽  
Patient Specific ◽  
Parent Artery ◽  
Basilar Tip Aneurysm ◽  
Wall Shear ◽  
Artery Flow

Therapeutic parent artery flow reversal is a treatment option for giant, partially thrombosed basilar tip aneurysms. The effectiveness of this treatment has been variable and not yet studied by applying computational fluid dynamics. Computed tomography images and blood flow velocities acquired with transcranial Doppler ultrasonography were obtained prior to and after bilateral endovascular vertebral artery occlusion for a giant basilar tip aneurysm. Patient-specific geometries and velocity waveforms were used in computational fluid dynamics simulations in order to determine the velocity and wall shear stress changes induced by treatment. Therapeutic parent artery flow reversal lead to a dramatic increase in aneurysm inflow and wall shear stress (30 to 170 Pa) resulting in an increase in intra-aneurysmal circulation. The enlargement of the circulated area within the aneurysm led to a re-normalization of the wall shear stress and the aneurysm remained stable for more than 8 years thereafter. Therapeutic parent artery flow reversal can lead to unintended, potentially harmful changes in aneurysm inflow which can be quantified and possibly predicted by applying computational fluid dynamics.

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