A Novel Flow Dynamics Study of the Intracranial Veins Using Whole Brain Four-Dimensional Computed Tomography Angiography.


Journal

World neurosurgery
ISSN: 1878-8769
Titre abrégé: World Neurosurg
Pays: United States
ID NLM: 101528275

Informations de publication

Date de publication:
Nov 2019
Historique:
received: 10 06 2019
revised: 11 07 2019
accepted: 12 07 2019
pubmed: 23 7 2019
medline: 28 1 2020
entrez: 23 7 2019
Statut: ppublish

Résumé

The flow dynamics of the intracranial venous channels are fundamentally important for understanding intracranial physiology and pathophysiology. However, the method clinically applicable to the evaluation of the flow dynamics of the intracranial venous system has not been well described in the reported data. We have developed a new method to evaluate intracranial venous flow direction and velocity using 4-dimensional (4D) computed tomography angiography (CTA). The aim of the present study was to verify the accuracy and validity of 4D-CTA in a clinical setting. We retrospectively analyzed 97 veins from 26 patients (16 cases of arteriovenous shunt disease, 9 intracranial tumor cases, and 1 cerebral aneurysm case) who had undergone both 4D-CTA and conventional digital subtraction angiography (DSA). Using 4D-CTA, we analyzed the time-density curve with gamma distribution extrapolation and obtained the direction of the flow and flow velocity of each vein. The direction of the flow in 4D-CTA was also collated with that obtained using conventional DSA to verify the experimental method. The direction of the flow determined by 4D-CTA was consistent with that of conventional DSA in 94.8% of cases. The average venous flow velocity was 64.3 mm/second and 81.8 mm/second, respectively, in the antegrade and retrograde channels affected by arteriovenous shunts. The present flow analysis using 4D-CTA enabled us to evaluate the direction and velocity of intracranial venous flow. Other than some limitations, the presented method is reliable and its potential for application in clinical settings is promising.

Sections du résumé

BACKGROUND BACKGROUND
The flow dynamics of the intracranial venous channels are fundamentally important for understanding intracranial physiology and pathophysiology. However, the method clinically applicable to the evaluation of the flow dynamics of the intracranial venous system has not been well described in the reported data. We have developed a new method to evaluate intracranial venous flow direction and velocity using 4-dimensional (4D) computed tomography angiography (CTA). The aim of the present study was to verify the accuracy and validity of 4D-CTA in a clinical setting.
METHODS METHODS
We retrospectively analyzed 97 veins from 26 patients (16 cases of arteriovenous shunt disease, 9 intracranial tumor cases, and 1 cerebral aneurysm case) who had undergone both 4D-CTA and conventional digital subtraction angiography (DSA). Using 4D-CTA, we analyzed the time-density curve with gamma distribution extrapolation and obtained the direction of the flow and flow velocity of each vein. The direction of the flow in 4D-CTA was also collated with that obtained using conventional DSA to verify the experimental method.
RESULTS RESULTS
The direction of the flow determined by 4D-CTA was consistent with that of conventional DSA in 94.8% of cases. The average venous flow velocity was 64.3 mm/second and 81.8 mm/second, respectively, in the antegrade and retrograde channels affected by arteriovenous shunts.
CONCLUSIONS CONCLUSIONS
The present flow analysis using 4D-CTA enabled us to evaluate the direction and velocity of intracranial venous flow. Other than some limitations, the presented method is reliable and its potential for application in clinical settings is promising.

Identifiants

pubmed: 31330333
pii: S1878-8750(19)32015-7
doi: 10.1016/j.wneu.2019.07.109
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

e176-e185

Informations de copyright

Copyright © 2019 Elsevier Inc. All rights reserved.

Auteurs

Katsuhiro Mizutani (K)

Department of Neurosurgery, Keio University School of Medicine, Tokyo, Japan; Service de Neuroradiologie Diagnostique et Thérapeutique, Hôpital Foch, Suresnes, France. Electronic address: katsu512@yahoo.co.jp.

Nobuhiko Arai (N)

Department of Neurosurgery, Keio University School of Medicine, Tokyo, Japan.

Masahiro Toda (M)

Department of Neurosurgery, Keio University School of Medicine, Tokyo, Japan.

Takenori Akiyama (T)

Department of Neurosurgery, Keio University School of Medicine, Tokyo, Japan.

Hirokazu Fujiwara (H)

Department of Radiology, Keio University School of Medicine, Tokyo, Japan.

Masahiro Jinzaki (M)

Department of Radiology, Keio University School of Medicine, Tokyo, Japan.

Kazunari Yoshida (K)

Department of Neurosurgery, Keio University School of Medicine, Tokyo, Japan.

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