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Research ArticleNeurointervention
Open Access

Quantification of Internal Carotid Artery Flow with Digital Subtraction Angiography: Validation of an Optical Flow Approach with Doppler Ultrasound

V. Mendes Pereira, R. Ouared, O. Brina, O. Bonnefous, J. Satwiaski, H. Aerts, D. Ruijters, F. van Nijnatten, F. Perren, P. Bijlenga, K. Schaller and K.-O. Lovblad
American Journal of Neuroradiology January 2014, 35 (1) 156-163; DOI: https://doi.org/10.3174/ajnr.A3662
V. Mendes Pereira
aFrom the Interventional Neuroradiology Unit (V.M.P., R.O., O. Brina, K.-O.L.)
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R. Ouared
aFrom the Interventional Neuroradiology Unit (V.M.P., R.O., O. Brina, K.-O.L.)
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O. Brina
aFrom the Interventional Neuroradiology Unit (V.M.P., R.O., O. Brina, K.-O.L.)
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O. Bonnefous
dMedisys Research Laboratory (O. Bonnefous, J.S.)
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J. Satwiaski
dMedisys Research Laboratory (O. Bonnefous, J.S.)
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H. Aerts
eInterventional X-Ray (H.A., D.R., F.v.N.), Philips Healthcare, Best, the Netherlands.
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D. Ruijters
eInterventional X-Ray (H.A., D.R., F.v.N.), Philips Healthcare, Best, the Netherlands.
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F. van Nijnatten
eInterventional X-Ray (H.A., D.R., F.v.N.), Philips Healthcare, Best, the Netherlands.
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F. Perren
cService of Neurology (F.P.), University Hospital of Geneva, Geneva, Switzerland
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P. Bijlenga
bService of Neurosurgery (P.B., K.S.)
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K. Schaller
bService of Neurosurgery (P.B., K.S.)
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K.-O. Lovblad
aFrom the Interventional Neuroradiology Unit (V.M.P., R.O., O. Brina, K.-O.L.)
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Figures

  • Fig 1.
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    Fig 1.

    Flowchart illustrating the treatment of DSA images to calculate the blood flow of patient 3. First, the 2D images are superimposed on the 3DRA to scale the distances on the 2D images (A). Next, the contrast values are distributed over a straight model (B) to extract a flow map from the contrast sequence. Last, the flow map is analyzed by using the optical flow principle to estimate flow velocity curves (C). The volume flow rate curve is estimated by using the section of the artery measured from the 3DRA volume.

  • Fig 2.
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    Fig 2.

    A and B, The regression fit at QI = 1.5 mL/s for QD ≤ 4 mL/s (left) and QD ≤ 7 mL/s (right). QX is represented on the y-axis, and QD, on the x-axis. The data (blue star points), fit (red line), and 95% CI limits (magenta) are all represented. C and D, The regression fit at Qi = 2.0 mL/s for QD ≤ 3 mL/s (left) and QD ≤ 7 mL/s (right). QX is represented on the y-axis and QD on the x-axis. The data (blue star points), fit (red line), and 95% CI limits (magenta) are all represented. E and F, The regression fit at Qi = 3.0 mL/s for QD ≤ 3 mL/s (left) and QD ≤ 7 mL/s (right). QX is represented on the y-axis, and QD, on the x-axis. The data (blue star points), fit (red line), and 95% CI limits (magenta) are all represented.

  • Fig 3.
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    Fig 3.

    A, the boxplot for the fitted slope (y-axis) at 1.5, 2.0, and 3 mL/s (x-axis). Each boxplot represents the 5 slope values fitted for each QD subsample, with QD thresholds ≤3.0, ≤4.0, ≤5.0, ≤6.0, and ≤7.0 mL/s. B, results of the nonparametric ANOVA multiple comparison of the regression slope upper limit (x-axis) for each injection rate group (y-axis). These summarize the corresponding maximum slope values of 0.84, 1.21, and 0.72 with an SE of 0.12. The 95% CI error margins are also represented.

  • Fig 4.
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    Fig 4.

    A, Slope versus QD for injection rates Qi = 1.5 (blue), 2.0 (red), and 3.0 mL/s (green). The 95% CI limits have been superimposed to Qi = 2.0 mL/s points. The graph shows that the slope bias calculated is not significantly different from 1 up to QD = 6 mL/s (P > .05). The Qi = 1.5 mL/s group (blue points) follows the same evolution trend as Qi = 2.0 mL/s, though with accentuated bias. A nonsignificant slope bias is likely for the QD range below 3 mL/s (P = .06). B, Injection rate quotients for Qi = 1.5 mL/s (group 1), 2.0 (group 2), and 3.0 mL/s (group 3). The blue bars correspond to quotients <1.2, and the red bars, to quotients >1.2. The fact that the Qi = 1.5 and 2.0 mL/s groups are reconstructed in similar ways with minimum slope bias, unlike the Qi = 3.0 mL/s group, is partly due to differences in injection rate quotients (P = .01).

  • Fig 5.
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    Fig 5.

    Comparison of contrast wave maps (top) and flow curves (bottom) for patient 13 for different IRs: IR = 1.5 mL/s (left), IR = 2.0 mL/s (middle), and IR = 3.0 mL/s (right). The red and blue curves in the bottom images correspond to USD and DSA measurements.

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American Journal of Neuroradiology: 35 (1)
American Journal of Neuroradiology
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1 Jan 2014
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V. Mendes Pereira, R. Ouared, O. Brina, O. Bonnefous, J. Satwiaski, H. Aerts, D. Ruijters, F. van Nijnatten, F. Perren, P. Bijlenga, K. Schaller, K.-O. Lovblad
Quantification of Internal Carotid Artery Flow with Digital Subtraction Angiography: Validation of an Optical Flow Approach with Doppler Ultrasound
American Journal of Neuroradiology Jan 2014, 35 (1) 156-163; DOI: 10.3174/ajnr.A3662

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Quantification of Internal Carotid Artery Flow with Digital Subtraction Angiography: Validation of an Optical Flow Approach with Doppler Ultrasound
V. Mendes Pereira, R. Ouared, O. Brina, O. Bonnefous, J. Satwiaski, H. Aerts, D. Ruijters, F. van Nijnatten, F. Perren, P. Bijlenga, K. Schaller, K.-O. Lovblad
American Journal of Neuroradiology Jan 2014, 35 (1) 156-163; DOI: 10.3174/ajnr.A3662
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Cited By...

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  • Intra-aneurysmal hemodynamics: evaluation of pCONus and pCANvas bifurcation aneurysm devices using DSA optical flow imaging
  • Assessment of intra-aneurysmal flow modification after flow diverter stent placement with four-dimensional flow MRI: a feasibility study
  • Changes of Time-Attenuation Curve Blood Flow Parameters in Patients with and without Carotid Stenosis
  • Intra-Aneurysmal Flow Patterns: Illustrative Comparison among Digital Subtraction Angiography, Optical Flow, and Computational Fluid Dynamics
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