J Neurol Surg A Cent Eur Neurosurg 2013; 74(05): 294-302
DOI: 10.1055/s-0033-1342937
Original Article
Georg Thieme Verlag KG Stuttgart · New York

Reproducibility of Image-Based Analysis of Cerebral Aneurysm Geometry and Hemodynamics: An In-Vitro Study of Magnetic Resonance Imaging, Computed Tomography, and Three-Dimensional Rotational Angiography

L. Goubergrits
1   Biofluid Mechanics Laboratory, Charité – Universitätsmedizin Berlin, Berlin, Germany
J. Schaller
1   Biofluid Mechanics Laboratory, Charité – Universitätsmedizin Berlin, Berlin, Germany
U. Kertzscher
1   Biofluid Mechanics Laboratory, Charité – Universitätsmedizin Berlin, Berlin, Germany
Ch Petz
2   Scientific Visualization, Konrad Zuse Institute, Berlin, Germany
H.-Ch Hege
2   Scientific Visualization, Konrad Zuse Institute, Berlin, Germany
A. Spuler
3   Department of Neurosurgery, Helios Hospital Berlin-Buch, Berlin, Germany
› Institutsangaben
Weitere Informationen


03. Oktober 2012

31. Dezember 2012

22. Mai 2013 (online)


Background and Study Aims Image-based computational fluid dynamics (CFD) provides a means for analysis of biofluid mechanical parameters of cerebral aneurysms. This may enable patient-specific rupture risk analysis and facilitate treatment decisions. Application of different imaging methods may, however, alter the geometrical basis of these studies. The present study compares geometry and hemodynamics of an aneurysm phantom model acquired by means of magnetic resonance imaging (MRI), computed tomography (CT), and rotational angiography (3DRA).

Materials and Methods The phantom model of a basilaris artery aneurysm was fabricated based on data generated by CT angiography. This model underwent imaging by means of CT, MRI, and 3DRA. We compared the geometrical reconstructions using the original dataset with those obtained from CT, MRI, and 3DRA. Similarly, CFD analyses were performed using the four reconstructions (3DRA, MRI, CT, and original dataset).

Results MRI and the 3DRA-based reconstructions yield mean reconstruction errors of 0.097 mm and 0.1 mm, which are by a factor of 2.5 better than the CT reconstruction. The maximal error for the aneurysm radius (7.11 mm) measurement was found in the 3DRA reconstruction and was 3.8% (0.28 mm). A comparison of calculated time-averaged wall shear stress (WSS) shows good correlations for the entire surface and, separately, for the surface of the aneurysmal sack. The maximal error of 8% of the mean WSS calculation of the whole surface was found for the CT reconstruction. The calculations of the aneurysmal sack mean WSS from the MRI reconstruction were estimated to have a maximal error of 7%.

Conclusion All three imaging techniques (CT, MRI, 3DRA) adequately reproduce aneurysm geometry and allow meaningful CFD analyses.

  • References

  • 1 Cebral JR, Castro MA, Appanaboyina S, Putman CM, Millan D, Frangi AF. Efficient pipeline for image-based patient-specific analysis of cerebral aneurysm hemodynamics: technique and sensitivity. IEEE Trans Med Imaging 2005; 24 (4) 457-467
  • 2 Shojima M, Oshima M, Takagi K , et al. Magnitude and role of wall shear stress on cerebral aneurysm: computational fluid dynamic study of 20 middle cerebral artery aneurysms. Stroke 2004; 35 (11) 2500-2505
  • 3 Castro MA, Putman CM, Cebral JR. Computational modeling of cerebral aneurysms in arterial networks reconstructed from multiple 3D rotational angiography images. In: Amini AA, Manduca A, , eds. Proceedings of the International Society for Optical Engineering (SPIE), Medical Imaging 2005; Physiology, Function, and Structure from Medical Images. 2005. 5746. 233-244
  • 4 Glor FP, Ariff B, Hughes AD , et al. Image-based carotid flow reconstruction: a comparison between MRI and ultrasound. Physiol Meas 2004; 25 (6) 1495-1509
  • 5 Glor FP, Long Q, Hughes AD , et al. Reproducibility study of magnetic resonance image-based computational fluid dynamics prediction of carotid bifurcation flow. Ann Biomed Eng 2003; 31 (2) 142-151
  • 6 Wellnhofer E, Osman J, Kertzscher U, Affeld K, Fleck E, Goubergrits L. Flow simulation studies in coronary arteries—impact of side-branches. Atherosclerosis 2010; 213 (2) 475-481
  • 7 Ali MH, Schumacker PT. Endothelial responses to mechanical stress: where is the mechanosensor?. Crit Care Med 2002; 30 (5, Suppl): S198-S206
  • 8 Busse R, Fleming I. Regulation of endothelium-derived vasoactive autacoid production by hemodynamic forces. Trends Pharmacol Sci 2003; 24 (1) 24-29
  • 9 Cirino G, Fiorucci S, Sessa WC. Endothelial nitric oxide synthase: the Cinderella of inflammation?. Trends Pharmacol Sci 2003; 24 (2) 91-95
  • 10 Griffith TM. Endothelial control of vascular tone by nitric oxide and gap junctions: a haemodynamic perspective. Biorheology 2002; 39 (3-4) 307-318
  • 11 Resnick N, Einav S, Chen-Konak L, Zilberman M, Yahav H, Shay-Salit A. Hemodynamic forces as a stimulus for arteriogenesis. Endothelium 2003; 10 (4-5) 197-206
  • 12 Wiebers DO, Whisnant JP, Huston III J , et al; International Study of Unruptured Intracranial Aneurysms Investigators. Unruptured intracranial aneurysms: natural history, clinical outcome, and risks of surgical and endovascular treatment. Lancet 2003; 362 (9378) 103-110
  • 13 Forget Jr TR, Benitez R, Veznedaroglu E , et al. A review of size and location of ruptured intracranial aneurysms. Neurosurgery 2001; 49 (6) 1322-1325 , discussion 1325–1326
  • 14 Nahed BV, DiLuna ML, Morgan T , et al. Hypertension, age, and location predict rupture of small intracranial aneurysms. Neurosurgery 2005; 57 (4) 676-683 , discussion 676–683
  • 15 Birchall D, Zaman A, Hacker J, Davies G, Mendelow D. Analysis of haemodynamic disturbance in the atherosclerotic carotid artery using computational fluid dynamics. Eur Radiol 2006; 16 (5) 1074-1083
  • 16 Gölitz P, Struffert T, Knossalla F , et al. Angiographic CT with intravenous contrast injection compared with conventional rotational angiography in the diagnostic work-up of cerebral aneurysms. AJNR Am J Neuroradiol 2012; 33 (5) 982-987
  • 17 Majoie CBLM, Sprengers ME, van Rooij WJJ , et al. MR angiography at 3T versus digital subtraction angiography in the follow-up of intracranial aneurysms treated with detachable coils. AJNR Am J Neuroradiol 2005; 26 (6) 1349-1356
  • 18 Geers AJ, Larrabide I, Radaelli AG , et al. Patient-specific computational hemodynamics of intracranial aneurysms from 3D rotational angiography and CT angiography: an in vivo reproducibility study. AJNR Am J Neuroradiol 2011; 32 (3) 581-586
  • 19 Pham DL, Xu C, Prince JL. Current methods in medical image segmentation. Annu Rev Biomed Eng 2000; 2: 315-337
  • 20 Lorensen WE, Cline HE. Marching cubes: a high resolution 3D surface construction algorithm. Proceeding SIGGRAPH '87 Proceedings of the 14th annual conference on Computer graphics and interactive techniques, Pages 163-169
  • 21 Boissonnat JD, Chaine R, Frey P , et al. From arteriographies to computational flow in saccular aneurisms: the INRIA experience. Med Image Anal 2005; 9 (2) 133-143
  • 22 Goubergrits L, Schaller J, Kertzscher U , et al. Statistical wall shear stress maps of ruptured and unruptured middle cerebral artery aneurysms. J R Soc Interface 2012; 9 (69) 677-688
  • 23 Goubergrits L, Kertzscher U, Schöneberg B, Wellnhofer E, Petz C, Hege HC. CFD analysis in an anatomically realistic coronary artery model based on non-invasive 3D imaging: comparison of magnetic resonance imaging with computed tomography. Int J Cardiovasc Imaging 2008; 24 (4) 411-421
  • 24 Myers JG, Moore JA, Ojha M, Johnston KW, Ethier CR. Factors influencing blood flow patterns in the human right coronary artery. Ann Biomed Eng 2001; 29 (2) 109-120
  • 25 Prakash S, Ethier CR. Requirements for mesh resolution in 3-D computational hemodynamics. J Biomech Eng 2001; 123 (2) 134-144
  • 26 Berthier B, Bouzerar R, Legallais C. Blood flow patterns in an anatomically realistic coronary vessel: influence of three different reconstruction methods. J Biomech 2002; 35 (10) 1347-1356
  • 27 Kato T, Indo T, Yoshida E, Iwasaki Y, Sone M, Sobue G. Contrast-enhanced 2D cine phase MR angiography for measurement of basilar artery blood flow in posterior circulation ischemia. AJNR Am J Neuroradiol 2002; 23 (8) 1346-1351
  • 28 Rutgers DR, Blankensteijn JD, van der Grond J. Preoperative MRA flow quantification in CEA patients: flow differences between patients who develop cerebral ischemia and patients who do not develop cerebral ischemia during cross-clamping of the carotid artery. Stroke 2000; 31 (12) 3021-3028
  • 29 Rayz VL, Boussel L, Acevedo-Bolton G , et al. Numerical simulations of flow in cerebral aneurysms: comparison of CFD results and in vivo MRI measurements. J Biomech Eng 2008; 130 (5) 051011
  • 30 Nijenhuis RJ, Jacobs MJ, Jaspers K , et al. Comparison of magnetic resonance with computed tomography angiography for preoperative localization of the Adamkiewicz artery in thoracoabdominal aortic aneurysm patients. J Vasc Surg 2007; 45 (4) 677-685
  • 31 Fleischmann D, Rubin GD, Paik DS , et al. Stair-step artifacts with single versus multiple detector-row helical CT. Radiology 2000; 216 (1) 185-196
  • 32 Ernemann UU, Grönewäller E, Duffner FB, Guervit O, Claassen J, Skalej MD. Influence of geometric and hemodynamic parameters on aneurysm visualization during three-dimensional rotational angiography: an in vitro study. AJNR Am J Neuroradiol 2003; 24 (4) 597-603
  • 33 Hiller J, Fuchs TJ, Kasperl S, Reindl L. Influence of the quality of x-ray computed tomography image on coordinate measurements: principles, measurements and simulations. TM: Technisches Messen 2011; 78: 334-347
  • 34 Hoogeveen RM, Bakker CJG, Viergever MA. Limits to the accuracy of vessel diameter measurement in MR angiography. J Magn Reson Imaging 1998; 8 (6) 1228-1235
  • 35 Dhar S, Tremmel M, Mocco J , et al. Morphology parameters for intracranial aneurysm rupture risk assessment. Neurosurgery 2008; 63 (2) 185-196 , discussion 196–197
  • 36 Raghavan ML, Ma B, Harbaugh RE. Quantified aneurysm shape and rupture risk. J Neurosurg 2005; 102 (2) 355-362
  • 37 Strother CM, Graves VB, Rappe A. Aneurysm hemodynamics: an experimental study. AJNR Am J Neuroradiol 1992; 13 (4) 1089-1095
  • 38 Tognetti F, Limoni P, Testa C. Aneurysm growth and hemodynamic stress. Surg Neurol 1983; 20 (1) 74-78
  • 39 He XJ, Ku DN. Pulsatile flow in the human left coronary artery bifurcation: average conditions. J Biomech Eng 1996; 118 (1) 74-82
  • 40 Lei M, Kleinstreuer C, Truskey GA. A focal stress gradient-dependent mass transfer mechanism for atherogenesis in branching arteries. Med Eng Phys 1996; 18 (4) 326-332
  • 41 Kleinstreuer C, Hyun S, Buchanan JR, Longest PW, Archie Jr JP, Truskey GA. Hemodynamic parameters and early intimal thickening in branching blood vessels. Crit Rev Biomed Eng 2001; 29 (1) 1-64
  • 42 Buchanan JR, Kleinstreuer C, Truskey GA, Lei M. Relation between non-uniform hemodynamics and sites of altered permeability and lesion growth at the rabbit aorto-celiac junction. Atherosclerosis 1999; 143 (1) 27-40
  • 43 Geers AJ, Larrabide I, Morales HG, Frangi AF. Comparison of steady-state and transient blood flow simulations of intracranial aneurysms. Conf Proc IEEE Eng Med Biol Soc 2010; 2010: 2622-2625
  • 44 Goubergrits L, Thamsen B, Berthe A , et al. In vitro study of near-wall flow in a cerebral aneurysm model with and without coils. AJNR Am J Neuroradiol 2010; 31 (8) 1521-1528
  • 45 Löw M, Perktold K, Raunig R. Hemodynamics in rigid and distensible saccular aneurysms: a numerical study of pulsatile flow characteristics. Biorheology 1993; 30 (3-4) 287-298
  • 46 Meng H, Swartz DD, Wang Z , et al. A model system for mapping vascular responses to complex hemodynamics at arterial bifurcations in vivo. Neurosurgery 2006; 59 (5) 1094-1100 , discussion 1100–1101
  • 47 Boecher-Schwarz HG, Ringel K, Kopacz L, Heimann A, Kempski O. Ex vivo study of the physical effect of coils on pressure and flow dynamics in experimental aneurysms. AJNR Am J Neuroradiol 2000; 21 (8) 1532-1536