Measuring blood velocity using 4D‐DSA: A feasibility study

Shaughnessy, Gabe; Schäfer, Sebastian; Speidel, Michael A.; Strother, Charles M.; Mistretta, Charles A.

doi:10.1002/mp.13120

Cited by 19 publications

(22 citation statements)

References 18 publications

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“…A velocity for the segment was determined from temporal shift and spatial distance information with a relative root-mean-square error of 11% and a Pearson correlation coefficient with phase contrast (PC)-MR imaging of r ¼ 0.835. 25 Shaughnessy et al 26 derived a similar shift from the phase signal in the Fourier domain to determine liquid velocities in a given 3D-printed, patient-specific vessel segment. In each vessel segment, the vessel centerline, discrete distances, and radii were determined.…”

Section: Clinical Applications Of 4d-dsamentioning

confidence: 99%

4D-DSA: Development and Current Neurovascular Applications

Ruedinger¹,

Schäfer

Speidel

et al. 2020

AJNR Am J Neuroradiol

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Originally described by Davis et al in 2013, 4D-Digital Subtraction Angiography (4D-DSA) has developed into a commercially available application of DSA in the angiography suite. 4D-DSA provides the user with 3D time-resolved images, allowing observation of a contrast bolus at any desired viewing angle through the vasculature and at any time point during the acquisition (any view at any time). 4D-DSA mitigates some limitations that are intrinsic to both 2D-and 3D-DSA images. The clinical applications for 4D-DSA include evaluations of AVMs and AVFs, intracranial aneurysms, and atherosclerotic occlusive disease. Recent advances in blood flow quantification using 4D-DSA indicate that these data provide both the velocity and geometric information necessary for the quantification of blood flow. In this review, we will discuss the development, acquisition, reconstruction, and current neurovascular applications of 4D-DSA volumes.

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Section: Clinical Applications Of 4d-dsamentioning

confidence: 99%

4D-DSA: Development and Current Neurovascular Applications

Ruedinger¹,

Schäfer

Speidel

et al. 2020

AJNR Am J Neuroradiol

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“…Quantitative flow and velocity measurements can be obtained using a previously validated 4D-DSA based algorithm described by Shaughnessy et al [7]. This technique relies on a frequency-domain analysis of the pulsatility of the time-attenuation curves as well as 3D geometric information obtained from the iodine signal [7]. Pulsatility refers to the temporal variation in image intensity at each point along a vessel caused by temporal variations in iodine concentration.…”

Section: Assessment Of Optimal Acquisition Parametersmentioning

confidence: 99%

“…These concentration variations are a natural result of the mixing of injected contrast agent with time-varying blood flow driven by the cardiac cycle. In this study, 4D-DSA reconstructions were processed using the above algorithm, which also provides a sideband ratio (SBR) metric as a measure of contrast pulsatility in 4D-DSA [7]. The SBR is a proxy for the signal-to-noise ratio of the cardiac pulsatile waveform, and, as such, is a major determinant of flow quantification performance [7].…”

Section: Assessment Of Optimal Acquisition Parametersmentioning

confidence: 99%

“…In this study, 4D-DSA reconstructions were processed using the above algorithm, which also provides a sideband ratio (SBR) metric as a measure of contrast pulsatility in 4D-DSA [7]. The SBR is a proxy for the signal-to-noise ratio of the cardiac pulsatile waveform, and, as such, is a major determinant of flow quantification performance [7]. A higher SBR has been associated with a higher correlation seen between 4D-DSA and intravascular Doppler blood velocities [6].…”

Section: Assessment Of Optimal Acquisition Parametersmentioning

confidence: 99%

“…For example, quantitative 4D-DSA was recently shown to be a feasible modality for quantifying hepatic blood flow and characterizing changes in flow during transarterial embolization [6]. However, the quality of the 4D-DSA reconstructions and resultant accuracy of the flow calculations was shown to be dependent on, and positively correlated with, the strength of the contrast pulsatility [7]. Maximizing the strength of pulsatility while maintaining a cross-sectional area with adequate filling would be ideal for 4D-DSA acquisitions.…”

Section: Introductionmentioning

confidence: 99%

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Optimization of quantitative time-resolved 3D (4D) digital subtraction angiography in a porcine liver model

et al. 2020

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Background: Time-resolved three-dimensional digital subtraction angiography (4D-DSA) can be used to quantify blood velocity. Contrast pulsatility, a major discriminant on 4D-DSA, is yet to be optimized. We investigated the effects of different imaging and injection parameters on sideband ratio (SBR), a measure of contrast pulsatile strength, within the hepatic vasculature of an in vivo porcine model. Methods: Fifty-nine hepatic 4D-DSA procedures were performed in three female domestic swine (mean weight 54 kg). Contrast injections were performed in the common hepatic artery with different combinations of imaging duration (6 s or 12 s), injection rates (from 1.0 to 2.5 mL/s), contrast concentration (50% or 100%), and catheter size (4 Fr or 5 Fr). Reflux was recorded. SBR and vessel cross-sectional areas were calculated in 289 arterial segments. Multiple linear mixed-effects models were estimated to determine the effects of parameters on SBR and cross-sectional vessel area. Results: Twelve-second acquisitions yielded a SBR higher than 6 s (p < 0.001). No significant differences in SBR were seen between different catheter sizes (p = 0.063) or contrast concentration (p = 0.907). For higher injection rates (2.5 mL/s), SBR was lower (p = 0.007) and cross-sectional area was higher (p < 0.001). Reflux of contrast does not significantly affect SBR (p = 0.087). Conclusions: The strength of contrast pulsatility used for flow quantitation with 4D-DSA can be increased by adjusting injection rates and using longer acquisition times. Reduction of contrast concentration to 50% is feasible and reflux of contrast does not significantly hinder contrast pulsatility.

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A novel angiographic method to estimate arterial blood flow rates using contrast reflux: Effect of injection parameters

et al. 2022

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Background Contrast reflux, which is the retrograde movement of contrast against flow direction, is commonly observed during angiography. Despite a vast body of literature on angiography, the hemodynamic factors affecting contrast reflux have not been studied. Numerous methods have been developed to extract flow from angiography, but the reliability of these methods is not yet sufficient to be of routine clinical use. Purpose To evaluate the effect of baseline blood flow rates and injection conditions on the extent of contrast reflux. To estimate arterial flow rates based on measurement of contrast reflux length. Materials and methods Iodinated contrast was injected into an idealized tube as well as a physiologically accurate model of the cervico‐cerebral vasculature. A total of 194 high‐speed angiograms were acquired under varying “blood” flow rates and injection conditions (catheter size, injection rate, and injection time). The length of contrast reflux was compared to the input variables and to dimensionless fluid dynamics parameters at the catheter‐tip. Arterial blood flow rates were estimated using contrast reflux length as well as a traditional transit‐time method and compared to measured flow rates. Results Contrast reflux lengths were significantly affected by contrast injection rate (p < 0.0001), baseline blood flow rate (p = 0.0004), and catheter size (p = 0.04), but not by contrast injection time (p = 0.4). Reflux lengths were found to be correlated to dimensionless fluid dynamics parameters by an exponential function (R2 = 0.6–0.99). When considering the entire dataset in unison, flow estimation errors with the reflux‐length method (39% ± 33%) were significantly higher (p = 0.003) than the transit‐time method (33% ± 36%). However, when subgrouped by catheter, the error with the reflux‐length method was substantially reduced and was significantly lower (14% ± 14%, p < 0.0001) than the transit‐time method. Conclusion Results show correlations between contrast reflux length and baseline hemodynamic parameters that have not been reported previously. Clinically relevant blood flow rate estimation is feasible by simple measurement of reflux length. In vivo and clinical studies are required to confirm these correlations and to refine the methodology of estimating blood flow by reflux.

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Measuring blood velocity using 4D‐DSA: A feasibility study

Cited by 19 publications

References 18 publications

4D-DSA: Development and Current Neurovascular Applications

4D-DSA: Development and Current Neurovascular Applications

Optimization of quantitative time-resolved 3D (4D) digital subtraction angiography in a porcine liver model

A novel angiographic method to estimate arterial blood flow rates using contrast reflux: Effect of injection parameters

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