Variations of shape, length, branching, and end trunks of M1 segment of middle cerebral artery

Reçi, Valvita; Bexheti, Sadi

doi:10.17352/jnnsd.000034

Cited by 6 publications

(3 citation statements)

References 10 publications

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“…thr l = 2 and thr h = 4 were more sensitive than the other two hyperparameters to image signal intensity and can be slightly tuned within ±2 to different cases. Given that typical diameter is approximately 5 mm for ICA, 31 1.9–3.5 mm for MCA M1 segment, 32 and 1.1–2.1 mm for MCA M2 segment, 33 the average centerline distance discrepancy was lower than the vessel radius. The normal segment also had a mean distance smaller than the voxel size of isotropic 0.55 mm.…”

Section: Discussionmentioning

confidence: 93%

VWI‐APP: Vessel wall imaging–dedicated automated processing pipeline for intracranial atherosclerotic plaque quantification

et al. 2022

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Background: Quantitative plaque assessment based on 3D magnetic resonance (MR) vessel wall imaging (VWI) has been shown to provide valuable numerical markers of the burden and risk of intracranial atherosclerotic disease (ICAD). However, plaque quantification is currently time-consuming and observer-dependent due to the demand for heavy manual effort. A VWI-dedicated automated processing pipeline (VWI-APP) is desirable. Purpose: To develop and evaluate a VWI-APP for end-to-end quantitative analysis of intracranial atherosclerotic plaque. Methods: We retrospectively enrolled 91 subjects with ICAD (80 for pipeline development, 10 for an end-to-end pipeline evaluation, and 1 for demonstrating longitudinal plaque assessment) who had undergone VWI and MR angiography. In an end-to-end evaluation, diameter stenosis (DS), normalized wall index (NWI), remodeling ratio (RR), plaque wall contrast ratio (CR), and total plaque volume (TPV) were quantified at each culprit lesion using the developed VWI-APP and a computer-aided manual approach by a neuroradiologist, respectively. The time consumed in each quantification approach was recorded. Two-sided paired t-tests and intraclass correlation coefficient (ICC) were used to determine the difference and agreement in each plaque metric between VWI-APP and manual quantification approaches. Results: There was no significant difference between VWI-APP and manual quantification in each plaque metric.The ICC was 0.890,0.813,0.827,0.891,and 0.991 for DS, NWI, RR, CR, and TPV, respectively, suggesting good to excellent accuracy of the pipeline method in plaque quantification. Quantitative analysis of each culprit lesion on average took 675.7 s using the manual approach but shortened to 238.3 s with the aid of VWI-APP. Conclusions: VWI-APP is an accurate and efficient approach to intracranial atherosclerotic plaque quantification. Further clinical assessment of this automated tool is warranted to establish its utility in the risk assessment of ICAD lesions.

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Section: Discussionmentioning

confidence: 93%

VWI‐APP: Vessel wall imaging–dedicated automated processing pipeline for intracranial atherosclerotic plaque quantification

et al. 2022

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“…Following studies using cadavers, investigators reported an MCA trunk mean length of 15 mm +/− 1.1 mm in the right hemisphere and 15.7 mm +/− 1.3 mm in the left hemisphere in 70 cerebral hemispheres that were studied [18]. Using similar approach in 50 cerebral hemispheres, investigators reported M1 segment mean length of 14.9 mm with a standard deviation of 1.2 mm [19]. A more recent study reported a mean length of the M1 segment of 20.6 mm with a standard deviation of 6.2 mm in 100 hemispheres and defined early bifurcation of the MCA as bifurcation occurring within 1 cm from the origin of MCA which was seen in 3% of the hemispheres [20].…”

Section: Classical/anatomical Classification Of Distal Arteriesmentioning

confidence: 99%

“…An example of an early bifurcation is shown in Figure 2a. The MCA trunk then enters the lateral fissure where it bifurcates (72%), trifurcates (16%), or terminates as a primary trunk (12%) [19]. MCA bifurcation was found in 86.2% and trifurcation in 13.8% of the cases [15].…”

Section: Classical/anatomical Classification Of Distal Arteriesmentioning

confidence: 99%

Angiographic Systems for Classifying Distal Arterial Occlusions

Pillai¹,

Mitchell²,

Phan³

et al. 2022

Cerebrovasc Dis

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Background: Extensive randomized controlled clinical trials for endovascular thrombectomy in anterior circulation large vessel occlusions (internal carotid arteries and M1 segment of middle cerebral arteries) have been published over the past decade, but there have not been randomized controlled trials for distal arterial occlusions to date. Distal arterial occlusion randomized controlled trials are essential to decide on patient selection, imaging criteria, and endovascular approach to improve the outcome and reduce complications. Summary: The definition of distal arterial occlusion is however unclear, and we believe that a uniform nomenclature of distal arterial occlusions is essential for the design of robust randomized controlled studies. We undertook a systematic literature review and comprehensive analysis of 70 articles looking at distal arterial occlusions and previous attempts at classifying them as well as comparing their similarities and differences with a more selective look at the middle cerebral artery. Thirty-two articles were finally deemed suitable and included for this review. In this review article, we present 3 disparate classifications of distal arterial occlusions, namely, classical/anatomical, functional/imaging, and structural/calibre, and compare the similarities and differences between them. Key Messages: We propose the adoption of functional/imaging classification to guide the identification of distal arterial occlusions with the M2 segment starting at the point of bifurcation of the middle cerebral artery trunk/M1 segment. With regards to the anterior temporal artery, we propose that it will be considered a branch of the M1 and only be considered as the M2 segment if it is a holo-temporal artery. We believe that this is a practical method of classification in the time-critical decision-making period.

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Design, manufacturing, and multi‐modal imaging of stereolithography 3D printed flexible intracranial aneurysm phantoms

Yalman,

Jafari,

Léger

et al. 2024

Medical Physics

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BackgroundPhysical vascular phantoms are instrumental in studying intracranial aneurysms and testing relevant imaging tools and training systems to provide improved clinical care. Current vascular phantom production methods have major limitations in capturing the biophysical and morphological characteristics of intracranial aneurysms with good fidelity and multi‐modal imaging capacity. With stereolithography (SLA) 3D printing technology becoming more accessible, newer flexible and transparent printing materials with higher precision controls open the door for improving the efficiency and quality of producing anthropomorphic vascular phantoms but have rarely been explored for the application.PurposeThis technical note intends to report the feasibility of using SLA 3D printing technology to manufacture flexible intracranial aneurysm phantoms with similar scales to the real anatomy, as well as their capacity for multi‐modal flow imaging and analysis, including ultrasound flow imaging, high‐speed filming, and particle image velocimetry analysis.MethodsWe designed and 3D‐printed two intracranial aneurysm phantoms with an SLA 3D printer using Formlabs Elastic 50A resin. By using a micropump to introduce cyclical flows in the phantoms, we first employed conventional Doppler and vector flow ultrasonography to observe and measure different fluidic properties. Then, a high‐speed camera was used to record particles flowing within the phantom, and we further conducted a particle image velocimetry analysis, including the distribution of mean 2D velocity vectors, average velocity magnitudes, and the mean vorticity fields in the phantom for the high‐speed imaging data.ResultsWe successfully 3D‐printed flexible intracranial aneurysm phantoms with similar dimensions to the real anatomy. Additionally, we validated the phantoms’ ability to allow visualization, measurement, and analysis of flow dynamics based on both real‐time ultrasound and optical imaging.ConclusionsOur proof‐of‐concept study illustrates that SLA 3D printing using commercial elastic resins can significantly contribute towards facilitating the fabrication of flexible intracranial aneurysms phantoms for training, research, and preoperative planning.

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Variations of shape, length, branching, and end trunks of M1 segment of middle cerebral artery

Cited by 6 publications

References 10 publications

VWI‐APP: Vessel wall imaging–dedicated automated processing pipeline for intracranial atherosclerotic plaque quantification

VWI‐APP: Vessel wall imaging–dedicated automated processing pipeline for intracranial atherosclerotic plaque quantification

Angiographic Systems for Classifying Distal Arterial Occlusions

Design, manufacturing, and multi‐modal imaging of stereolithography 3D printed flexible intracranial aneurysm phantoms

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