Quantitative analysis of flow vortices: differentiation of unruptured and ruptured medium-sized middle cerebral artery a
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ORIGINAL ARTICLE - VASCULAR NEUROSURGERY - ANEURYSM
Quantitative analysis of flow vortices: differentiation of unruptured and ruptured medium-sized middle cerebral artery aneurysms K. Sunderland 1 & M. Wang 2 & A. S. Pandey 3 & J. Gemmete 4 & Q. Huang 5 & A. Goudge 1 & J. Jiang 1,6 Received: 4 July 2020 / Accepted: 9 October 2020 # Springer-Verlag GmbH Austria, part of Springer Nature 2020
Abstract Background Surgical intervention for unruptured intracranial aneurysms (IAs) carries inherent health risks. The analysis of “patient-specific” IA geometric and computational fluid dynamics (CFD) simulated wall shear stress (WSS) data has been investigated to differentiate IAs at high and low risk of rupture to help clinical decision making. Yet, outcomes vary among studies, suggesting that novel analysis could improve rupture characterization. The authors describe a CFD analytic method to assess spatiotemporal characteristics of swirling flow vortices within IAs to improve characterization. Methods CFD simulations were performed for 47 subjects harboring one medium-sized (4–10 mm) middle cerebral artery (MCA) aneurysm with available 3D digital subtraction angiography data. Alongside conventional indices, quantified IA flow vortex spatiotemporal characteristics were applied during statistical characterization. Statistical supervised machine learning using a support vector machine (SVM) method was run with cross-validation (100 iterations) to assess flow vortex-based metrics’ strength toward rupture characterization. Results Relying solely on vortex indices for statistical characterization underperformed compared with established geometric characteristics (total accuracy of 0.77 vs 0.80) yet showed improvements over wall shear stress models (0.74). However, the application of vortex spatiotemporal characteristics into the combined geometric and wall shear stress parameters augmented model strength for assessing the rupture status of middle cerebral artery aneurysms (0.85). Conclusions This preliminary study suggests that the spatiotemporal characteristics of flow vortices within MCA aneurysms are of value to improve the differentiation of ruptured aneurysms from unruptured ones. Keywords Aneurysm . Computational fluid dynamics . Rupture status characterization . Flow vortex
Abbreviations AUC CFD
Area under the curve Computational fluid dynamics
IA MCA NVS
Intracranial aneurysms Middle cerebral artery Normalized vortex surface
This article is part of the Topical Collection on Vascular Neurosurgery Aneurysm Electronic supplementary material The online version of this article (https://doi.org/10.1007/s00701-020-04616-y) contains supplementary material, which is available to authorized users. * J. Jiang [email protected] 1
Biomedical Engineering, Michigan Technological University, Houghton, MI, USA
2
Department of Management Science and Statistics, The University of Texas at San Antonio, San Antonio, TX, USA
3
Department of Neurosurgery, University of Michigan, Ann Arbor, MI, USA
4
Department of Radiology, Universi
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