The purpose of this study was to develop and validate a method for automated segmentation of the carotid artery lumen from volumetric MR Angiographic (MRA) images using a deformable tubular 3D Non-Uniform Rational B-Splines (NURBS) model. A flexible 3D tubular NURBS model was designed to delineate the carotid arterial lumen. User interaction was allowed to guide the model by placement of forbidden areas. Contrast-enhanced MRA (CE-MRA) from 21 patients with carotid atherosclerotic disease were included in this study. The validation was performed against expert drawn contours on multi-planar reformatted image slices perpendicular to the artery. Excellent linear correlations were found on cross-sectional area measurement (r = 0.98, P < 0.05) and on luminal diameter (r = 0.98, P < 0.05). Strong match in terms of the Dice similarity indices were achieved: 0.95 ± 0.02 (common carotid artery), 0.90 ± 0.07 (internal carotid artery), 0.87 ± 0.07 (external carotid artery), 0.88 ± 0.09 (carotid bifurcation) and 0.75 ± 0.20 (stenosed segments). Slight overestimation of stenosis grading by the automated method was observed. The mean differences was 7.20% (SD = 21.00%) and 5.2% (SD = 21.96%) when validated against two observers. Reproducibility in stenosis grade calculation by the automated method was high; the mean difference between two repeated analyses was 1.9 ± 7.3%. In conclusion, the automated method shows high potential for clinical application in the analysis of CE-MRA of carotid arteries.
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http://dx.doi.org/10.1007/s10554-011-9988-x | DOI Listing |
J Neurosurg Case Lessons
January 2025
Department of Neurosurgery, Kanto Rosai Hospital, Kanagawa, Japan.
Background: The presence of significant tortuosity in access routes to aneurysms can interfere with catheter guidance and manipulation and significantly impact treatment strategies.
Observations: In this report, the authors combined intentional staged aneurysm embolization with the construction of a new direct access route, which they call a "highway bypass," for a symptomatic posterior circulation cerebral aneurysm that was difficult to access with a catheter. Notably, the highway bypass is used for catheter passage, and technical tips should be considered.
J Neurosurg Case Lessons
January 2025
Department of Neurosurgery, Institute of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan.
Background: Carotid webs are rare nonatherosclerotic disorders in the carotid artery and are increasingly recognized as factors of ischemic stroke in the young population. Asymptomatic webs can be treated with antithrombotic therapy, whereas symptomatic cases frequently require surgical interventions, including carotid endarterectomy (CEA). However, guidelines for the optimal timing of these treatments remain unestablished, especially compared to atherosclerotic stenotic lesions, due to the rarity of carotid webs.
View Article and Find Full Text PDFBr J Hosp Med (Lond)
December 2024
Department of Stroke Center, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China.
Ischemic stroke (IS), a cerebrovascular condition, is commonly detected by evaluating carotid intima-media (CIA) stenosis. Symptomatic CIA stenosis carries a high risk (up to 32%) of another ischemic event within 12 weeks, while asymptomatic CIA stenosis has an annual risk ranging from 1% to 2%. Therefore, this study aims to explore the diagnostic value of clinical features and carotid plaque characteristics in both symptomatic and asymptomatic IS.
View Article and Find Full Text PDFZh Nevrol Psikhiatr Im S S Korsakova
January 2025
Pirogov Russian National Research Medical University (Pirogov University), Moscow, Russia.
The article considers the issues of clinical presentation, diagnosis and treatment of arterial dissection, a common cause of ischemic stroke at a young age. The causes, predisposing factors and pathophysiological foundations of the development of this disease are discussed. It is noted that arterial dissection is often accompanied by non-specific clinical manifestations, which complicates the diagnosis.
View Article and Find Full Text PDFZh Nevrol Psikhiatr Im S S Korsakova
January 2025
Pirogov City Clinical Hospital No. 1, Moscow, Russia.
Objective: To study the associations of genetic markers influencing the residual reactivity of platelets during antiplatelet therapy with acetylsalicylic acid, and clinical and laboratory parameters, including parameters of the platelet hemostasis, in patients with non-cardioembolic ischemic stroke (IS) for a deeper understanding of the pathogenetic mechanisms and prediction of response to therapy and clinical outcome.
Material And Methods: The study included 296 patients (average age 64.65 [55; 76] years) undergoing treatment at the City Clinical Hospital named after.
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