BACKGROUND AND PURPOSE: Flow-diverter stents modify intra-aneurysmal blood flow and induce the progressive thrombosis of intracranial aneurysms followed by stable vascular reconstruction. The aim of this study was to report a new method for the appraisal of intracranial blood flow from DSA performed during endovascular treatment procedures.
The Doppler effect is usually described as a frequency shift of the backscattered signals from moving targets with respect to the frequency transmitted. Recently, real-time blood flow imaging has become possible thanks to the development of a new velocity estimator based on phase-shift measurements of successive echoes. However, this method suffers from the well-known limitations of pulse-Doppler instruments. A new formulation is presented which describes the pulse-Doppler effect on the successive echoes from a cloud of moving targets as a progressive translation in time due to the displacement of the scatterers between two excitations. This approach allows us to generate efficiently computer-simulated data in order to evaluate accurately the various processing techniques. Furthermore, it leads to a novel class of velocity estimators in the time domain which measure the time shifts which are proportional to the local blood velocity. Among them, the cross correlation of the received rf signals turns out to be well suited. A local cross-correlation function is first calculated from a consecutive pair of range-gated echoes and the time shift is then determined by searching for the time position with the maximum correlation. The time-correlation technique is shown to provide accurate velocity profiles with broadband transducers. Moreover, the classical velocity limitation of pulse-Doppler is overcome because there is no ambiguity in measuring a time shift instead of a phase shift. These major advantages should make quantitative flow mapping possible and more reliable.
With the increased availability of computational resources, the past decade has seen a rise in the use of computational fluid dynamics (CFD) for medical applications. There has been an increase in the application of CFD to attempt to predict the rupture of intracranial aneurysms, however, while many hemodynamic parameters can be obtained from these computations, to date, no consistent methodology for the prediction of the rupture has been identified. One particular challenge to CFD is that many factors contribute to its accuracy; the mesh resolution and spatial/temporal discretization can alone contribute to a variation in accuracy. This failure to identify the importance of these factors and identify a methodology for the prediction of ruptures has limited the acceptance of CFD among physicians for rupture prediction. The International CFD Rupture Challenge 2013 seeks to comment on the sensitivity of these various CFD assumptions to predict the rupture by undertaking a comparison of the rupture and blood-flow predictions from a wide range of independent participants utilizing a range of CFD approaches. Twenty-six groups from 15 countries took part in the challenge. Participants were provided with surface models of two intracranial aneurysms and asked to carry out the corresponding hemodynamics simulations, free to choose their own mesh, solver, and temporal discretization. They were requested to submit velocity and pressure predictions along the centerline and on specified planes. The first phase of the challenge, described in a separate paper, was aimed at predicting which of the two aneurysms had previously ruptured and where the rupture site was located. The second phase, described in this paper, aims to assess the variability of the solutions and the sensitivity to the modeling assumptions. Participants were free to choose boundary conditions in the first phase, whereas they were prescribed in the second phase but all other CFD modeling parameters were not prescribed. In order to compare the computational results of one representative group with experimental results, steady-flow measurements using particle image velocimetry (PIV) were carried out in a silicone model of one of the provided aneurysms. Approximately 80% of the participating groups generated similar results. Both velocity and pressure computations were in good agreement with each other for cycle-averaged and peak-systolic predictions. Most apparent "outliers" (results that stand out of the collective) were observed to have underestimated velocity levels compared to the majority of solutions, but nevertheless identified comparable flow structures. In only two cases, the results deviate by over 35% from the mean solution of all the participants. Results of steady CFD simulations of the representative group and PIV experiments were in good agreement. The study demonstrated that while a range of numerical schemes, mesh resolution, and solvers was used, similar flow predictions were observed in the majority of cases. To further validate the computati...
The in vitro and clinical results indicate that it is feasible to estimate blood flow in routine interventional procedures. The availability of an x-ray based method for quantitative flow estimation is particularly clinically useful for intra-cranial applications, where other methods, such as ultrasound Doppler, are not available.
The Doppler effect is usually described as a frequency shift of the backscattered signals from moving targets with respect to the frequency transmitted. Recently, real-time blood flow imaging has become possible thanks to the development of a new velocity estimator based on phase-shift measurements of successive echoes. However, this method suffers from the well-known limitations of pulse-Doppler instruments. A new formulation is presented which describes the pulse-Doppler effect on the successive echoes from a cloud of moving targets as a progressive translation in time due to the displacement of the scatterers between two excitations. This approach allows us to generate efficiently computer-simulated data in order to evaluate accurately the various processing techniques. Furthermore, it leads to a novel class of velocity estimators in the time domain which measure the time shifts which are proportional to the local blood velocity. Among them, the cross correlation of the received rf signals turns out to be well suited. A local cross-correlation function is first calculated from a consecutive pair of range-gated echoes and the time shift is then determined by searching for the time position with the maximum correlation. The time-correlation technique is shown to provide accurate velocity profiles with broadband transducers. Moreover, the classical velocity limitation of pulse-Doppler is overcome because there is no ambiguity in measuring a time shift instead of a phase shift. These major advantages should make quantitative flow mapping possible and more reliable.
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