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PT  - JOURNAL ARTICLE
AU  - Ruedinger, K.L.
AU  - Harvey, E.C.
AU  - Schafer, S.
AU  - Speidel, M.A.
AU  - Strother, C.M.
TI  - Optimizing the Quality of 4D-DSA Temporal Information
AID  - 10.3174/ajnr.A6290
DP  - 2019 Dec 01
TA  - American Journal of Neuroradiology
PG  - 2124--2129
VI  - 40
IP  - 12
4099  - http://www.ajnr.org/content/40/12/2124.short
4100  - http://www.ajnr.org/content/40/12/2124.full
SO  - Am. J. Neuroradiol.2019 Dec 01; 40
AB  - BACKGROUND AND PURPOSE: Quantification of blood flow using a 4D-DSA would be useful in the diagnosis and treatment of cerebrovascular diseases. A protocol optimizing identification of density variations in the time-density curves of a 4D-DSA has not been defined. Our purpose was to determine the contrast injection protocol most likely to result in the optimal pulsatility signal strength.MATERIALS AND METHODS: Two 3D-printed patient-specific models were used and connected to a pulsatile pump and flow system, which delivered 250–260 mL/min to the model. Contrast medium (Isovue, 370 mg I/mL, 75% dilution) was injected through a 6F catheter positioned upstream from the inlet of the model. 4D-DSA acquisitions were performed for the following injection rates: 1.5, 2.0, 2.5, 3.0 and 3.5 mL/s for 8 seconds. To determine pulsatility, we analyzed the time-density curve at the inlets using the oscillation amplitude and a previously described numeric metric, the sideband ratio. Vascular geometry from 4D-DSA reconstructions was compared with ground truth and micro-CT measurements of the model. Dimensionless numbers that characterize hemodynamics, Reynolds and Craya-Curtet, were calculated for each injection rate.RESULTS: The strongest pulsatility signal occurred with the 2.5 mL/s injections. The largest oscillation amplitudes were found with 2.0- and 2.5-mL/s injections. Geometric accuracy was best preserved with injection rates of &amp;gt;1.5 mL/s.CONCLUSIONS: An injection rate of 2.5 mL/s provided the strongest pulsatility signal in the 4D-DSA time-density curve. Geometric accuracy was best preserved with injection rates above 1.5 mL/s. These results may be useful in future in vivo studies of blood flow quantification.CtCraya-Curtet numberSBRsideband ratioTDCtime-density curve