The knowledge of cerebrovascular variants is essential in education, training, diagnosis and treatment. The current way of presentation of vasculature and, particularly, vascular variants is insufficient. Our purpose is to construct a three-dimensional (3D) interactive atlas of cerebral arterial variants along with exploration tools allowing the investigator just with a few clicks to better and faster understand the variants and their spatial relationships. A 3D model of the cerebral arterial system created earlier, fully labeled with names and diameters, is used as a reference. As the vast material about vascular variability is incomplete and not fully documented, our approach synthesizes variants in 3D based on existing knowledge. The variants are created from literature using a dedicated vascular editor and embedded into the reference model. Sixty 3D variants and branching patterns are created including the internal carotid, middle cerebral, anterior cerebral, posterior cerebral, vertebral and basilar arteries, and circle of Willis. Their prevalence rates are given. The atlas is developed to explore the variants individually or embedded into the reference vasculature. Real-time interactive manipulation of variants and reference vasculature (rotate/zoom/pan/view) is provided. This atlas facilitates the investigator to easily get familiarized with the variants and rapidly explore them. It aids in presentation of vascular variants and understanding their spatial relationships either individually or embedded into the surrounding reference cerebrovasculature. It is useful for medical students, educators to prepare teaching materials, and clinicians for scan interpretation. It is easily extensible with additional variant instances, new variants, branching patterns, and supporting textual materials.

The increasing complexity of human body models enabled by advances in diagnostic imaging, computing, and growing knowledge calls for the development of a new generation of systems for intelligent exploration of these models. Here, we introduce a novel paradigm for the exploration of digital body models illustrating cerebral vasculature. It enables dynamic scene compositing, real-time interaction combined with animation, correlation of 3D models with sectional images, quantification as well as 3D manipulation-independent labeling and knowledge-related meta labeling (with name, diameter, description, variants, and references). This novel exploration is incorporated into a 3D atlas of cerebral vasculature with arteries and veins along with the surrounding surface and sectional neuroanatomy derived from 3.0 Tesla scans. This exploration paradigm is useful in medical education, training, research, and clinical applications. It enables development of new generation systems for rapid and intelligent exploration of complicated digital body models in real time with dynamic scene compositing from highly parcellated 3D models, continuous navigation, and manipulation-independent labeling with multiple features.

Inserting devices into the brain during microrecording and stimulation may cause microbleeds not discernible on standard scans. A small change in the location of the DBS electrode can result in a major change for the patient. The described simulation increases the neurosurgeon's awareness of this phenomenon. The simulator enables the neurosurgeon to analyze the spatial relationships between the track and the cerebrovasculature, ventricles, subcortical structures, and cortical areas, which allows the DBS electrode to be placed more effectively, and thus potentially reducing the invasiveness of the stimulation procedure for the patient.

The proposed algorithm is robust to head rotation, and correctly identifies the MSP for a standard clinical CT scan with a large slice thickness. It has been applied in our several CT stroke CAD systems.