Enhancing cerebral arteriovenous malformation analysis: Development and application of patient-specific lumped parameter models based on 3D imaging data.

Objectives: Cerebral arteriovenous malformations (AVMs) present complex neurovascular challenges, characterized by direct arteriovenous connections that disrupt normal brain blood flow dynamics. Traditional lumped parameter models (LPMs) offer a simplified angioarchitectural representation of AVMs, yet often fail to capture the intricate structure within the AVM nidus. This research aims at refining our understanding of AVM hemodynamics through the development of patient-specific LPMs utilizing three-dimensional (3D) medical imaging data for enhanced structural fidelity.

Methods: This study commenced with the meticulous delineation of AVM vascular architecture using threshold segmentation and skeletonization techniques. The AVM nidus's core structure was outlined, facilitating the extraction of vessel connections and the formation of a detailed fistulous vascular tree model. Sampling points, spatially distributed and derived from the pixel intensity in imaging data, guided the construction of a complex plexiform tree within the nidus by generating smaller Y-shaped vascular formations. This model was then integrated with an electrical analog model to enable precise numerical simulations of cerebral hemodynamics with AVMs.

Results: The study successfully generated two distinct patient-specific AVM networks, mirroring the unique structural and morphological characteristics of the AVMs as captured in medical imaging. The models effectively represented the intricate fistulous and plexiform vessel structures within the nidus. Numerical analysis of these models revealed that AVMs induce a blood shunt effect, thereby diminishing blood perfusion to adjacent brain tissues.

Conclusion: This investigation enhances the theoretical framework for AVM research by constructing patient-specific LPMs that accurately reflect the true vascular structures of AVMs. These models offer profound insights into the hemodynamic behaviors of AVMs, including their impact on cerebral circulation and the blood steal phenomenon. Further incorporation of clinical data into these models holds the promise of deepening the theoretical comprehension of AVMs and fostering advancements in the diagnosis and treatment of AVMs.