Quantitative and qualitative comparison of 4D-DSA with 3D-DSA using computational fluid dynamics simulations in cerebral aneurysms

Abstract

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 (rmaximum diameter = 0.98, Pmaximum diameter < .002; rpressure systole=0.9, Ppressure systole