Neurovascular stent artifacts in 3D-TOF and 3D-PCMRI: Influence of stent design on flow measurement
Corresponding Author
Pierre Bouillot
Departement of Neuroradiology, Geneva University Hospitals, Geneva, Switzerland
Laboratory for Hydraulic Machines (LMH), École Polytechnique Fédérale de Lausanne (EPFL), Lausanne, Switzerland
Correspondence
P. Bouillot, Service de Neuroradiologie, Hôpitaux Universitaires de Genève, Rue Gabrielle-Perret-Gentil 4, Geneva, CH-1211, Switzerland.
Email: [email protected]
Search for more papers by this authorOlivier Brina
Departement of Neuroradiology, Geneva University Hospitals, Geneva, Switzerland
Division of Neuroradiology, Department of Medical Imaging, Toronto Western Hospital, University Health Network, Toronto, Ontario, Canada
Search for more papers by this authorBénédicte M. A. Delattre
Division of Radiology, Geneva University Hospitals, University of Geneva, Geneva, Switzerland
Search for more papers by this authorRafik Ouared
Departement of Neuroradiology, Geneva University Hospitals, Geneva, Switzerland
Search for more papers by this authorAlain Pellaton
Departement of Neuroradiology, Geneva University Hospitals, Geneva, Switzerland
Search for more papers by this authorHasan Yilmaz
Departement of Neuroradiology, Geneva University Hospitals, Geneva, Switzerland
Search for more papers by this authorPaolo Machi
Departement of Neuroradiology, Geneva University Hospitals, Geneva, Switzerland
Search for more papers by this authorKarl-Olof Lovblad
Departement of Neuroradiology, Geneva University Hospitals, Geneva, Switzerland
Search for more papers by this authorMohamed Farhat
Laboratory for Hydraulic Machines (LMH), École Polytechnique Fédérale de Lausanne (EPFL), Lausanne, Switzerland
Search for more papers by this authorVitor Mendes Pereira
Departement of Neuroradiology, Geneva University Hospitals, Geneva, Switzerland
Division of Neuroradiology, Department of Medical Imaging, Toronto Western Hospital, University Health Network, Toronto, Ontario, Canada
Division of Neurosurgery, Department of Surgery, Toronto Western Hospital, University Health Network, Toronto, Ontario, Canada
Search for more papers by this authorMaria Isabel Vargas
Departement of Neuroradiology, Geneva University Hospitals, Geneva, Switzerland
Search for more papers by this authorCorresponding Author
Pierre Bouillot
Departement of Neuroradiology, Geneva University Hospitals, Geneva, Switzerland
Laboratory for Hydraulic Machines (LMH), École Polytechnique Fédérale de Lausanne (EPFL), Lausanne, Switzerland
Correspondence
P. Bouillot, Service de Neuroradiologie, Hôpitaux Universitaires de Genève, Rue Gabrielle-Perret-Gentil 4, Geneva, CH-1211, Switzerland.
Email: [email protected]
Search for more papers by this authorOlivier Brina
Departement of Neuroradiology, Geneva University Hospitals, Geneva, Switzerland
Division of Neuroradiology, Department of Medical Imaging, Toronto Western Hospital, University Health Network, Toronto, Ontario, Canada
Search for more papers by this authorBénédicte M. A. Delattre
Division of Radiology, Geneva University Hospitals, University of Geneva, Geneva, Switzerland
Search for more papers by this authorRafik Ouared
Departement of Neuroradiology, Geneva University Hospitals, Geneva, Switzerland
Search for more papers by this authorAlain Pellaton
Departement of Neuroradiology, Geneva University Hospitals, Geneva, Switzerland
Search for more papers by this authorHasan Yilmaz
Departement of Neuroradiology, Geneva University Hospitals, Geneva, Switzerland
Search for more papers by this authorPaolo Machi
Departement of Neuroradiology, Geneva University Hospitals, Geneva, Switzerland
Search for more papers by this authorKarl-Olof Lovblad
Departement of Neuroradiology, Geneva University Hospitals, Geneva, Switzerland
Search for more papers by this authorMohamed Farhat
Laboratory for Hydraulic Machines (LMH), École Polytechnique Fédérale de Lausanne (EPFL), Lausanne, Switzerland
Search for more papers by this authorVitor Mendes Pereira
Departement of Neuroradiology, Geneva University Hospitals, Geneva, Switzerland
Division of Neuroradiology, Department of Medical Imaging, Toronto Western Hospital, University Health Network, Toronto, Ontario, Canada
Division of Neurosurgery, Department of Surgery, Toronto Western Hospital, University Health Network, Toronto, Ontario, Canada
Search for more papers by this authorMaria Isabel Vargas
Departement of Neuroradiology, Geneva University Hospitals, Geneva, Switzerland
Search for more papers by this authorFunding information: Swiss National Science Foundation, Grant/Award Number: SNF 32003B_160222, SNF 320030_156813
Abstract
Purpose
The morphological and hemodynamic evaluations of neurovascular diseases treated with stents would benefit from noninvasive imaging techniques such as 3D time-of-flight MRI (3D-TOF) and 3D phase contrast MRI (3D-PCMRI). For this purpose, a comprehensive evaluation of the stent artifacts and their impact on the flow measurement is critical.
Methods
The artifacts of a representative sample of neurovascular stents were evaluated in vitro with 3D-TOF and 3D-PCMRI sequences. The dependency of the artifacts with respect to the orientation was analyzed for each stent design as well as the impact on the flow measurement accuracy. Furthermore, the 3D-PCMRI data of four patients carrying intracranial aneurysms treated with flow diverter stents were analyzed as illustrative examples.
Results
The stent artifacts were mainly confined to the stent lumen therefore indicating the leading role of shielding effect. The influence of the stent design and its orientation with respect to the transmitting MR coils were highlighted. The artifacts impacted the 3D-PCMRI velocities mainly in the low magnitude domains, which were discarded from the analysis ensuring reliable near-stent velocities. The feasibility of in-stent flow measurements was confirmed in vivo on two patients who showed strong correlation between flow and geometric features. In two other patients, the consistency of out-of-stent velocities was verified qualitatively through intra-aneurysmal streamlines except when susceptibility artifacts occurred.
Conclusion
The present results motivate the conception of low inductance or nonconductive stent design. Furthermore, the feasibility of near-stent 3D-PCMRI measurements opens the door to clinical applications like the post-treatment follow-up of stenoses or intracranial aneurysms.
Supporting Information
| Filename | Description |
|---|---|
| mrm27352-sup-0001-suppinfofs1.pdfPDF document, 6.8 MB |
FIGURE S1 Qualitative and quantitative evaluation of stent artifacts on 3D-TOF, parallel (blue) and orthogonal (red) to the magnetic field
|
| mrm27352-sup-0002-suppinfofs2.pdfPDF document, 7.1 MB |
FIGURE S2 Qualitative and quantitative evaluation of stent artifacts on 3D-PCMRI, parallel (blue) and orthogonal (red) to the magnetic field
|
. For each stent, the mid-plane 3D-TOF magnitude interpolated from raw MRI dataset is displayed in gray-scale together with its quantitative value
along the center of the tube normalized with the out-of-stent vessel magnitude (
). The vertical dashed lines show the physical limits of the stents while the horizontal dotted lines represent the out-of-stent vessel magnitude. The direction of flow is from right to left. For guidance, a vasoCT volume rendering of each stent provides the location of the radio-opaque wires and markers
. For each stent, the mid-plane 3D-PCMRI magnitude interpolated from raw MRI dataset is displayed in gray-scale together with its quantitative value
along the center of the tube normalized with the out-of-stent vessel magnitude (
). Due to shielding in the stent lumen the calculated values of mean flow rate (q) and maximal through-plane time averaged velocity (
) show deviations from the real values assuming a Poiseuille flow, which are indicated by the dotted lines. The extent of the deviations depends on the individual stents. The vertical dashed lines show the physical limits of the stents. The direction of flow is from right to left. For guidance, a vasoCT volume rendering of each stent provides the location of the radio-opaque wires and markersPlease note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.
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