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<meta name="DC.Title" content="Quantitative and Qualitative Comparison of 4D-DSA with 3D-DSA Using Computational Fluid Dynamics Simulations in Cerebral Aneurysms" />
<meta name="DC.Identifier" content="10.3174/ajnr.A6172" />
<meta name="DC.Date" content="2019-09-01" />
<meta name="DC.Publisher" content="American Journal of Neuroradiology" />
<meta name="DC.Rights" content="© 2019 by American Journal of Neuroradiology" />
<meta name="DC.AccessRights" content="restricted" />
<meta name="DC.Description" content="BACKGROUND AND PURPOSE: 4D-DSA allows time-resolved 3D imaging of the cerebral vasculature. The aim of our study was to evaluate this method in comparison with the current criterion standard 3D-DSA by qualitative and quantitative means using computational fluid dynamics.

MATERIALS AND METHODS: 3D- and 4D-DSA datasets were acquired in patients with cerebral aneurysms. Computational fluid dynamics analysis was performed for all datasets. Using computational fluid dynamics, we compared 4D-DSA with 3D-DSA in terms of both aneurysmal geometry (quantitative: maximum diameter, ostium size [OZ1/2], volume) and hemodynamic parameters (qualitative: flow stability, flow complexity, inflow concentration; quantitative: average/maximum wall shear stress, impingement zone, low-stress zone, intra-aneurysmal pressure, and flow velocity). Qualitative parameters were descriptively analyzed. Correlation coefficients ( r , P value) were calculated for quantitative parameters.

RESULTS: 3D- and 4D-DSA datasets of 10 cerebral aneurysms in 10 patients were postprocessed. Evaluation of aneurysmal geometry with 4D-DSA ( r maximum diameter = 0.98, P maximum diameter &lt;.001; r OZ1/OZ2 = 0.98/0.86, P OZ1/OZ2 &lt; .001/.002; r volume = 0.98, P volume &lt;.001) correlated highly with 3D-DSA. Evaluation of qualitative hemodynamic parameters (flow stability, flow complexity, inflow concentration) did show complete accordance, and evaluation of quantitative hemodynamic parameters ( r average/maximum wall shear stress diastole = 0.92/0.88, P average/maximum wall shear stress diastole &lt; .001/.001; r average/maximum wall shear stress systole = 0.94/0.93, P average/maximum wall shear stress systole &lt; .001/.001; r impingement zone = 0.96, P impingement zone &lt; .001; r low-stress zone = 1.00, P low-stress zone = .01; r pressure diastole = 0.84, P pressure diastole = .002; r pressure systole = 0.9, P pressure systole &lt; .001; r flow velocity diastole = 0.95, P flow velocity diastole &lt; .001; r flow velocity systole = 0.93, P flow velocity systole &lt; .001) did show nearly complete accordance between 4D- and 3D-DSA.

CONCLUSIONS: Despite a different injection protocol, 4D-DSA is a reliable basis for computational fluid dynamics analysis of the intracranial vasculature and provides equivalent visualization of aneurysm geometry compared with 3D-DSA.

AWSS
:   average wall shear stress
CFD
:   computational fluid dynamics
dmax
:   maximum diameter
IZ
:   impingement zone
LSZ
:   low-stress zone
MWSS
:   maximum wall shear stress
OZ
:   ostium size
r 
:   correlation coefficient
V
:   flow velocity
WSS
:   wall shear stress" />
<meta name="DC.Contributor" content="S. Lang" />
<meta name="DC.Contributor" content="P. Hoelter" />
<meta name="DC.Contributor" content="A.I. Birkhold" />
<meta name="DC.Contributor" content="M. Schmidt" />
<meta name="DC.Contributor" content="J. Endres" />
<meta name="DC.Contributor" content="C. Strother" />
<meta name="DC.Contributor" content="A. Doerfler" />
<meta name="DC.Contributor" content="H. Luecking" />
<meta name="article:published_time" content="2019-09-01" />
<meta name="article:section" content="Interventional" />
<meta name="citation_title" content="Quantitative and Qualitative Comparison of 4D-DSA with 3D-DSA Using Computational Fluid Dynamics Simulations in Cerebral Aneurysms" />
<meta name="citation_abstract" lang="en" content="&lt;h3&gt;BACKGROUND AND PURPOSE:&lt;/h3&gt;
&lt;p&gt;4D-DSA allows time-resolved 3D imaging of the cerebral vasculature. The aim of our study was to evaluate this method in comparison with the current criterion standard 3D-DSA by qualitative and quantitative means using computational fluid dynamics.&lt;/p&gt;&lt;h3&gt;MATERIALS AND METHODS:&lt;/h3&gt;
&lt;p&gt;3D- and 4D-DSA datasets were acquired in patients with cerebral aneurysms. Computational fluid dynamics analysis was performed for all datasets. Using computational fluid dynamics, we compared 4D-DSA with 3D-DSA in terms of both aneurysmal geometry (quantitative: maximum diameter, ostium size [OZ1/2], volume) and hemodynamic parameters (qualitative: flow stability, flow complexity, inflow concentration; quantitative: average/maximum wall shear stress, impingement zone, low-stress zone, intra-aneurysmal pressure, and flow velocity). Qualitative parameters were descriptively analyzed. Correlation coefficients (&lt;i&gt;r&lt;/i&gt;, &lt;i&gt;P&lt;/i&gt; value) were calculated for quantitative parameters.&lt;/p&gt;&lt;h3&gt;RESULTS:&lt;/h3&gt;
&lt;p&gt;3D- and 4D-DSA datasets of 10 cerebral aneurysms in 10 patients were postprocessed. Evaluation of aneurysmal geometry with 4D-DSA (&lt;i&gt;r&lt;/i&gt;&lt;sub&gt;maximum diameter&lt;/sub&gt; = 0.98, &lt;i&gt;P&lt;/i&gt;&lt;sub&gt;maximum diameter&lt;/sub&gt; &amp;lt;.001; &lt;i&gt;r&lt;/i&gt;&lt;sub&gt;OZ1/OZ2&lt;/sub&gt; = 0.98/0.86, &lt;i&gt;P&lt;/i&gt;&lt;sub&gt;OZ1/OZ2&lt;/sub&gt; &amp;lt; .001/.002; &lt;i&gt;r&lt;/i&gt;&lt;sub&gt;volume&lt;/sub&gt; = 0.98, &lt;i&gt;P&lt;/i&gt;&lt;sub&gt;volume&lt;/sub&gt; &amp;lt;.001) correlated highly with 3D-DSA. Evaluation of qualitative hemodynamic parameters (flow stability, flow complexity, inflow concentration) did show complete accordance, and evaluation of quantitative hemodynamic parameters (&lt;i&gt;r&lt;/i&gt;&lt;sub&gt;average/maximum wall shear stress diastole&lt;/sub&gt; = 0.92/0.88, &lt;i&gt;P&lt;/i&gt;&lt;sub&gt;average/maximum wall shear stress diastole&lt;/sub&gt; &amp;lt; .001/.001; &lt;i&gt;r&lt;/i&gt;&lt;sub&gt;average/maximum wall shear stress systole&lt;/sub&gt; = 0.94/0.93, &lt;i&gt;P&lt;/i&gt;&lt;sub&gt;average/maximum wall shear stress systole&lt;/sub&gt; &amp;lt; .001/.001; &lt;i&gt;r&lt;/i&gt;&lt;sub&gt;impingement zone&lt;/sub&gt; = 0.96, &lt;i&gt;P&lt;/i&gt;&lt;sub&gt;impingement zone&lt;/sub&gt; &amp;lt; .001; &lt;i&gt;r&lt;/i&gt;&lt;sub&gt;low-stress zone&lt;/sub&gt; = 1.00, &lt;i&gt;P&lt;/i&gt;&lt;sub&gt;low-stress zone&lt;/sub&gt; = .01; &lt;i&gt;r&lt;/i&gt;&lt;sub&gt;pressure diastole&lt;/sub&gt; = 0.84, &lt;i&gt;P&lt;/i&gt;&lt;sub&gt;pressure diastole&lt;/sub&gt; = .002; &lt;i&gt;r&lt;/i&gt;&lt;sub&gt;pressure systole&lt;/sub&gt; = 0.9, &lt;i&gt;P&lt;/i&gt;&lt;sub&gt;pressure systole&lt;/sub&gt; &amp;lt; .001; &lt;i&gt;r&lt;/i&gt;&lt;sub&gt;flow velocity diastole&lt;/sub&gt; = 0.95, &lt;i&gt;P&lt;/i&gt;&lt;sub&gt;flow velocity diastole&lt;/sub&gt; &amp;lt; .001; &lt;i&gt;r&lt;/i&gt;&lt;sub&gt;flow velocity systole&lt;/sub&gt; = 0.93, &lt;i&gt;P&lt;/i&gt;&lt;sub&gt;flow velocity systole&lt;/sub&gt; &amp;lt; .001) did show nearly complete accordance between 4D- and 3D-DSA.&lt;/p&gt;&lt;h3&gt;CONCLUSIONS:&lt;/h3&gt;
&lt;p&gt;Despite a different injection protocol, 4D-DSA is a reliable basis for computational fluid dynamics analysis of the intracranial vasculature and provides equivalent visualization of aneurysm geometry compared with 3D-DSA.&lt;/p&gt;" />
<meta name="citation_journal_title" content="American Journal of Neuroradiology" />
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<meta name="twitter:title" content="Quantitative and Qualitative Comparison of 4D-DSA with 3D-DSA Using Computational Fluid Dynamics Simulations in Cerebral Aneurysms" />
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<meta name="twitter:description" content="BACKGROUND AND PURPOSE: 4D-DSA allows time-resolved 3D imaging of the cerebral vasculature. The aim of our study was to evaluate this method in comparison with the current criterion standard 3D-DSA by qualitative and quantitative means using computational fluid dynamics.

MATERIALS AND METHODS: 3D- and 4D-DSA datasets were acquired in patients with cerebral aneurysms. Computational fluid dynamics analysis was performed for all datasets. Using computational fluid dynamics, we compared 4D-DSA with 3D-DSA in terms of both aneurysmal geometry (quantitative: maximum diameter, ostium size [OZ1/2], volume) and hemodynamic parameters (qualitative: flow stability, flow complexity, inflow concentration; quantitative: average/maximum wall shear stress, impingement zone, low-stress zone, intra-aneurysmal pressure, and flow velocity). Qualitative parameters were descriptively analyzed. Correlation coefficients ( r , P value) were calculated for quantitative parameters.

RESULTS: 3D- and 4D-DSA datasets of 10 cerebral aneurysms in 10 patients were postprocessed. Evaluation of aneurysmal geometry with 4D-DSA ( r maximum diameter = 0.98, P maximum diameter &lt;.001; r OZ1/OZ2 = 0.98/0.86, P OZ1/OZ2 &lt; .001/.002; r volume = 0.98, P volume &lt;.001) correlated highly with 3D-DSA. Evaluation of qualitative hemodynamic parameters (flow stability, flow complexity, inflow concentration) did show complete accordance, and evaluation of quantitative hemodynamic parameters ( r average/maximum wall shear stress diastole = 0.92/0.88, P average/maximum wall shear stress diastole &lt; .001/.001; r average/maximum wall shear stress systole = 0.94/0.93, P average/maximum wall shear stress systole &lt; .001/.001; r impingement zone = 0.96, P impingement zone &lt; .001; r low-stress zone = 1.00, P low-stress zone = .01; r pressure diastole = 0.84, P pressure diastole = .002; r pressure systole = 0.9, P pressure systole &lt; .001; r flow velocity diastole = 0.95, P flow velocity diastole &lt; .001; r flow velocity systole = 0.93, P flow velocity systole &lt; .001) did show nearly complete accordance between 4D- and 3D-DSA.

CONCLUSIONS: Despite a different injection protocol, 4D-DSA is a reliable basis for computational fluid dynamics analysis of the intracranial vasculature and provides equivalent visualization of aneurysm geometry compared with 3D-DSA.

AWSS
:   average wall shear stress
CFD
:   computational fluid dynamics
dmax
:   maximum diameter
IZ
:   impingement zone
LSZ
:   low-stress zone
MWSS
:   maximum wall shear stress
OZ
:   ostium size
r 
:   correlation coefficient
V
:   flow velocity
WSS
:   wall shear stress" />
<meta name="og-title" property="og:title" content="Quantitative and Qualitative Comparison of 4D-DSA with 3D-DSA Using Computational Fluid Dynamics Simulations in Cerebral Aneurysms" />
<meta name="og-url" property="og:url" content="http://ajnr-stage2.stage.highwire.org/content/40/9/1505" />
<meta name="og-site-name" property="og:site_name" content="American Journal of Neuroradiology" />
<meta name="og-description" property="og:description" content="BACKGROUND AND PURPOSE: 4D-DSA allows time-resolved 3D imaging of the cerebral vasculature. The aim of our study was to evaluate this method in comparison with the current criterion standard 3D-DSA by qualitative and quantitative means using computational fluid dynamics.

MATERIALS AND METHODS: 3D- and 4D-DSA datasets were acquired in patients with cerebral aneurysms. Computational fluid dynamics analysis was performed for all datasets. Using computational fluid dynamics, we compared 4D-DSA with 3D-DSA in terms of both aneurysmal geometry (quantitative: maximum diameter, ostium size [OZ1/2], volume) and hemodynamic parameters (qualitative: flow stability, flow complexity, inflow concentration; quantitative: average/maximum wall shear stress, impingement zone, low-stress zone, intra-aneurysmal pressure, and flow velocity). Qualitative parameters were descriptively analyzed. Correlation coefficients ( r , P value) were calculated for quantitative parameters.

RESULTS: 3D- and 4D-DSA datasets of 10 cerebral aneurysms in 10 patients were postprocessed. Evaluation of aneurysmal geometry with 4D-DSA ( r maximum diameter = 0.98, P maximum diameter &lt;.001; r OZ1/OZ2 = 0.98/0.86, P OZ1/OZ2 &lt; .001/.002; r volume = 0.98, P volume &lt;.001) correlated highly with 3D-DSA. Evaluation of qualitative hemodynamic parameters (flow stability, flow complexity, inflow concentration) did show complete accordance, and evaluation of quantitative hemodynamic parameters ( r average/maximum wall shear stress diastole = 0.92/0.88, P average/maximum wall shear stress diastole &lt; .001/.001; r average/maximum wall shear stress systole = 0.94/0.93, P average/maximum wall shear stress systole &lt; .001/.001; r impingement zone = 0.96, P impingement zone &lt; .001; r low-stress zone = 1.00, P low-stress zone = .01; r pressure diastole = 0.84, P pressure diastole = .002; r pressure systole = 0.9, P pressure systole &lt; .001; r flow velocity diastole = 0.95, P flow velocity diastole &lt; .001; r flow velocity systole = 0.93, P flow velocity systole &lt; .001) did show nearly complete accordance between 4D- and 3D-DSA.

CONCLUSIONS: Despite a different injection protocol, 4D-DSA is a reliable basis for computational fluid dynamics analysis of the intracranial vasculature and provides equivalent visualization of aneurysm geometry compared with 3D-DSA.

AWSS
:   average wall shear stress
CFD
:   computational fluid dynamics
dmax
:   maximum diameter
IZ
:   impingement zone
LSZ
:   low-stress zone
MWSS
:   maximum wall shear stress
OZ
:   ostium size
r 
:   correlation coefficient
V
:   flow velocity
WSS
:   wall shear stress" />
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    <div class="highwire-article-citation highwire-citation-type-highwire-article node69904--5" data-node-nid="69904" id="top-node-69904--6197037670" data-pisa="ajnr;40/9/1505" data-pisa-master="ajnr;ajnr.A6172" data-apath="/ajnr/40/9/1505.atom" data-hw-author-tooltip-instance="highwire_author_tooltip"><div class="highwire-cite highwire-cite-highwire-article highwire-citation-jcore-article-title-complete clearfix has-author-tooltip highwire-citation-highwire-article-top-a">
  
  
      <div class="highwire-cite-overline"><span  class="highwire-cite-metadata-article-type highwire-cite-metadata">Research Article</span><span class="separator-pipe"></span><span  class="highwire-cite-metadata-art-cat highwire-cite-metadata"><span class="wrapper">Interventional</span></span></div>
  
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      <h1 class="highwire-cite-title" id="page-title">Quantitative and Qualitative Comparison of 4D-DSA with 3D-DSA Using Computational Fluid Dynamics Simulations in Cerebral Aneurysms</h1>  
    	<div class="highwire-cite-authors"><span  class="highwire-citation-authors"><span class="highwire-citation-author first" data-delta="0">S. Lang</span>, <span class="highwire-citation-author" data-delta="1">P. Hoelter</span>, <span class="highwire-citation-author" data-delta="2">A.I. Birkhold</span>, <span class="highwire-citation-author" data-delta="3">M. Schmidt</span>, <span class="highwire-citation-author" data-delta="4">J. Endres</span>, <span class="highwire-citation-author" data-delta="5">C. Strother</span>, <span class="highwire-citation-author" data-delta="6">A. Doerfler</span> and <span class="highwire-citation-author" data-delta="7">H. Luecking</span></span></div>
  
    	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-journal highwire-cite-metadata">American Journal of Neuroradiology </span><span  class="highwire-cite-metadata-date highwire-cite-metadata">September 2019,  </span><span  class="highwire-cite-metadata-volume highwire-cite-metadata">40 </span><span  class="highwire-cite-metadata-issue highwire-cite-metadata">(9) </span><span  class="highwire-cite-metadata-pages highwire-cite-metadata">1505-1510; </span><span  class="highwire-cite-metadata-doi highwire-cite-metadata">DOI: https://doi.org/10.3174/ajnr.A6172 </span></div>
  
  
  
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<div id="hw-article-author-popups-top-node-69904--6197037670" style="display: none;"><div class="author-tooltip-0"><div class="author-tooltip-name">S. Lang </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>a</span>From the Department of Neuroradiology (S.L., P.H., M.S., J.E., A.D., H.L.), University of Erlangen-Nuremberg, Erlangen, Germany</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=S.%2BLang%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Lang%20S&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AS.%2BLang%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="https://orcid.org/0000-0003-2426-4644" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for S. Lang</a></li></ul></div><div class="author-tooltip-1"><div class="author-tooltip-name">P. Hoelter </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>a</span>From the Department of Neuroradiology (S.L., P.H., M.S., J.E., A.D., H.L.), University of Erlangen-Nuremberg, Erlangen, Germany</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=P.%2BHoelter%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Hoelter%20P&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AP.%2BHoelter%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="https://orcid.org/0000-0001-9768-9630" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for P. Hoelter</a></li></ul></div><div class="author-tooltip-2"><div class="author-tooltip-name">A.I. Birkhold </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>b</span>Siemens Healthcare GmbH (A.I.B.), Erlangen, Germany</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=A.I.%2BBirkhold%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Birkhold%20A&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AA.I.%2BBirkhold%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="https://orcid.org/0000-0002-6375-4745" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for A.I. Birkhold</a></li></ul></div><div class="author-tooltip-3"><div class="author-tooltip-name">M. Schmidt </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>a</span>From the Department of Neuroradiology (S.L., P.H., M.S., J.E., A.D., H.L.), University of Erlangen-Nuremberg, Erlangen, Germany</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=M.%2BSchmidt%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Schmidt%20M&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AM.%2BSchmidt%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="https://orcid.org/0000-0002-8560-2582" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for M. Schmidt</a></li></ul></div><div class="author-tooltip-4"><div class="author-tooltip-name">J. Endres </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>a</span>From the Department of Neuroradiology (S.L., P.H., M.S., J.E., A.D., H.L.), University of Erlangen-Nuremberg, Erlangen, Germany</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=J.%2BEndres%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Endres%20J&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AJ.%2BEndres%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="https://orcid.org/0000-0002-1942-4802" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for J. Endres</a></li></ul></div><div class="author-tooltip-5"><div class="author-tooltip-name">C. Strother </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>c</span>Department of Radiology (C.S.), Clinical Sciences Center, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin.</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=C.%2BStrother%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Strother%20C&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AC.%2BStrother%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="https://orcid.org/0000-0002-4235-8081" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for C. Strother</a></li></ul></div><div class="author-tooltip-6"><div class="author-tooltip-name">A. Doerfler </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>a</span>From the Department of Neuroradiology (S.L., P.H., M.S., J.E., A.D., H.L.), University of Erlangen-Nuremberg, Erlangen, Germany</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=A.%2BDoerfler%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Doerfler%20A&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AA.%2BDoerfler%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="https://orcid.org/0000-0002-3076-3231" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for A. Doerfler</a></li></ul></div><div class="author-tooltip-7"><div class="author-tooltip-name">H. Luecking </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>a</span>From the Department of Neuroradiology (S.L., P.H., M.S., J.E., A.D., H.L.), University of Erlangen-Nuremberg, Erlangen, Germany</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=H.%2BLuecking%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Luecking%20H&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AH.%2BLuecking%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="https://orcid.org/0000-0002-3935-0003" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for H. 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    <div class="highwire-markup"><div xmlns="http://www.w3.org/1999/xhtml" data-highwire-cite-ref-tooltip-instance="highwire_reflinks_tooltip" class="content-block-markup" xmlns:xhtml="http://www.w3.org/1999/xhtml"><div class="article abstract-view "><span class="highwire-journal-article-marker-start"></span><div class="section abstract" id="abstract-1"><h2>Abstract</h2><div id="sec-1" class="subsection"><p id="p-2"><strong>BACKGROUND AND PURPOSE:</strong> 4D-DSA allows time-resolved 3D imaging of the cerebral vasculature. The aim of our study was to evaluate this method in comparison with the current criterion standard 3D-DSA by qualitative and quantitative means using computational fluid dynamics.</p></div><div id="sec-2" class="subsection"><p id="p-3"><strong>MATERIALS AND METHODS:</strong> 3D- and 4D-DSA datasets were acquired in patients with cerebral aneurysms. Computational fluid dynamics analysis was performed for all datasets. Using computational fluid dynamics, we compared 4D-DSA with 3D-DSA in terms of both aneurysmal geometry (quantitative: maximum diameter, ostium size [OZ1/2], volume) and hemodynamic parameters (qualitative: flow stability, flow complexity, inflow concentration; quantitative: average/maximum wall shear stress, impingement zone, low-stress zone, intra-aneurysmal pressure, and flow velocity). Qualitative parameters were descriptively analyzed. Correlation coefficients (<em>r</em>, <em>P</em> value) were calculated for quantitative parameters.</p></div><div id="sec-3" class="subsection"><p id="p-4"><strong>RESULTS:</strong> 3D- and 4D-DSA datasets of 10 cerebral aneurysms in 10 patients were postprocessed. Evaluation of aneurysmal geometry with 4D-DSA (<em>r</em><sub>maximum diameter</sub> = 0.98, <em>P</em><sub>maximum diameter</sub> &lt;.001; <em>r</em><sub>OZ1/OZ2</sub> = 0.98/0.86, <em>P</em><sub>OZ1/OZ2</sub> &lt; .001/.002; <em>r</em><sub>volume</sub> = 0.98, <em>P</em><sub>volume</sub> &lt;.001) correlated highly with 3D-DSA. Evaluation of qualitative hemodynamic parameters (flow stability, flow complexity, inflow concentration) did show complete accordance, and evaluation of quantitative hemodynamic parameters (<em>r</em><sub>average/maximum wall shear stress diastole</sub> = 0.92/0.88, <em>P</em><sub>average/maximum wall shear stress diastole</sub> &lt; .001/.001; <em>r</em><sub>average/maximum wall shear stress systole</sub> = 0.94/0.93, <em>P</em><sub>average/maximum wall shear stress systole</sub> &lt; .001/.001; <em>r</em><sub>impingement zone</sub> = 0.96, <em>P</em><sub>impingement zone</sub> &lt; .001; <em>r</em><sub>low-stress zone</sub> = 1.00, <em>P</em><sub>low-stress zone</sub> = .01; <em>r</em><sub>pressure diastole</sub> = 0.84, <em>P</em><sub>pressure diastole</sub> = .002; <em>r</em><sub>pressure systole</sub> = 0.9, <em>P</em><sub>pressure systole</sub> &lt; .001; <em>r</em><sub>flow velocity diastole</sub> = 0.95, <em>P</em><sub>flow velocity diastole</sub> &lt; .001; <em>r</em><sub>flow velocity systole</sub> = 0.93, <em>P</em><sub>flow velocity systole</sub> &lt; .001) did show nearly complete accordance between 4D- and 3D-DSA.</p></div><div id="sec-4" class="subsection"><p id="p-5"><strong>CONCLUSIONS:</strong> Despite a different injection protocol, 4D-DSA is a reliable basis for computational fluid dynamics analysis of the intracranial vasculature and provides equivalent visualization of aneurysm geometry compared with 3D-DSA.</p></div></div><div class="section glossary" id="glossary-1"><h2 class="">ABBREVIATIONS:</h2><dl id="def-list-1"><dt id="def-item-1">AWSS<span class="def-item-dt-sep"></span></dt><dd>average wall shear stress<span class="def-item-dd-sep"></span></dd><dt id="def-item-2">CFD<span class="def-item-dt-sep"></span></dt><dd>computational fluid dynamics<span class="def-item-dd-sep"></span></dd><dt id="def-item-3">d<sub>max</sub><span class="def-item-dt-sep"></span></dt><dd>maximum diameter<span class="def-item-dd-sep"></span></dd><dt id="def-item-4">IZ<span class="def-item-dt-sep"></span></dt><dd>impingement zone<span class="def-item-dd-sep"></span></dd><dt id="def-item-5">LSZ<span class="def-item-dt-sep"></span></dt><dd>low-stress zone<span class="def-item-dd-sep"></span></dd><dt id="def-item-6">MWSS<span class="def-item-dt-sep"></span></dt><dd>maximum wall shear stress<span class="def-item-dd-sep"></span></dd><dt id="def-item-7">OZ<span class="def-item-dt-sep"></span></dt><dd>ostium size<span class="def-item-dd-sep"></span></dd><dt id="def-item-8"><em>r</em><span class="def-item-dt-sep"></span></dt><dd>correlation coefficient<span class="def-item-dd-sep"></span></dd><dt id="def-item-9">V<span class="def-item-dt-sep"></span></dt><dd>flow velocity<span class="def-item-dd-sep"></span></dd><dt id="def-item-10">WSS<span class="def-item-dt-sep"></span></dt><dd>wall shear stress</dd></dl></div><ul class="copyright-statement"><li class="fn" id="copyright-statement-1">© 2019 by American Journal of Neuroradiology</li></ul><span class="highwire-journal-article-marker-end"></span></div><span class="related-urls"></span></div><a href="http://ajnr-stage2.stage.highwire.org/content/40/9/1505.full" class="hw-link hw-link-article-full-text" data-icon-position="" data-hide-link-title="0">View Full Text</a></div>  </div>

  
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        	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-volume highwire-cite-metadata">Vol. 40</span>, <span  class="highwire-cite-metadata-issue highwire-cite-metadata">Issue 9 </span><div  class="highwire-cite-metadata-pubdate highwire-cite-metadata">1 Sep 2019 </div></div>
      
      
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    	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-journal highwire-cite-metadata">American Journal of Neuroradiology </span><span  class="highwire-cite-metadata-date highwire-cite-metadata">Sep 2019, </span><span  class="highwire-cite-metadata-volume highwire-cite-metadata">40 </span><span  class="highwire-cite-metadata-issue highwire-cite-metadata">(9) </span><span  class="highwire-cite-metadata-pages highwire-cite-metadata">1505-1510; </span><span  class="highwire-cite-metadata-doi highwire-cite-metadata"><span class="label">DOI:</span> 10.3174/ajnr.A6172 </span></div>
  
  
  
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