Intracranial aneurysm neck size overestimation with 3D rotational angiography: the impact on intra-aneurysmal hemodynamics simulated with computational fluid dynamics

3DRA is considered the reference standard for the assessment of intracranial aneurysm morphology. However, it has been shown that 3DRA may overestimate neck size compared with 2D DSA. The purpose of this study was to determine the impact of neck size overestimation with 3DRA on intra-aneurysmal hemo...

Full description

Saved in:
Bibliographic Details
Published in:American journal of neuroradiology : AJNR 2013-01, Vol.34 (1), p.121-128
Main Authors: Schneiders, J J, Marquering, H A, Antiga, L, van den Berg, R, VanBavel, E, Majoie, C B
Format: Article
Language:English
Subjects:
Adult
Arterial Pressure
Blood Flow Velocity
Cerebral Angiography - methods
Computer Simulation
Female
Humans
Imaging, Three-Dimensional - methods
Interventional
Intracranial Aneurysm - diagnostic imaging
Intracranial Aneurysm - physiopathology
Male
Middle Aged
Models, Cardiovascular
Reproducibility of Results
Rotation
Sensitivity and Specificity
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:3DRA is considered the reference standard for the assessment of intracranial aneurysm morphology. However, it has been shown that 3DRA may overestimate neck size compared with 2D DSA. The purpose of this study was to determine the impact of neck size overestimation with 3DRA on intra-aneurysmal hemodynamics. In a series of 20 patients, 20 intracranial aneurysms were analyzed for aneurysm neck size overestimation with 3DRA compared with 2D DSA. 3DRA-derived vascular models were modified to agree with 2D DSA. Geometric and hemodynamic variables of the original and modified vascular models were compared. In 8 of the 20 evaluated cases, 3DRA-derived aneurysm models showed neck size overestimation compared with 2D DSA images. The average neck diameter reduction after modification was 19%, which was, on average, 0.85 mm (±0.32 mm). Modification of the neck resulted in differences in location of inflow jet (2/8), impingement zone (3/8), and low WSS area (4/8). In 1 case, the maximal WSS increased by 98% after modification. The change of impingement zone location resulted in a different classification of the impingement zone region in 2 cases. Neck size overestimation on 3DRA can have non-negligible consequences for hemodynamic features determined with CFD.
ISSN:0195-6108
1936-959X
DOI:10.3174/ajnr.A3179