Journal of Neurology Research, ISSN 1923-2845 print, 1923-2853 online, Open Access
Article copyright, the authors; Journal compilation copyright, J Neurol Res and Elmer Press Inc
Journal website http://www.neurores.org

Original Article

Volume 7, Number 3, June 2017, pages 25-38


An Enhanced Patient-Specific Computer Model Using an Iterative Multi-Staged Algorithm

Figures

Figure 1.
Figure 1. Enhanced sector model of cerebral circulation with the following 13 sectors: right and left middle cerebral sectors (RMC and LMC sectors), right and left anterior cerebral sectors (RAC and LAC sectors), right and left posterior cerebral sectors (RPC and LPC sectors), basilar sector (B sector), vertebral sector (V sector), right and left extracranial sectors (REC and LEC sectors), right and left subclavian sectors (RSUB and LSUB sectors), and abdominal aorta sector (ABD sector). The dashed lines represent the anastomosis between anterior cerebral sectors and middle cerebral sectors, and between posterior cerebral sectors and middle cerebral sectors.
Figure 2.
Figure 2. Multi-staged algorithm.
Figure 3.
Figure 3. Sector-adjustor with flow source or pressure source (Period-Init: 10, Period-Max: 100, Num-Adjust-Max: 5).
Figure 4.
Figure 4. β-adjustor.
Figure 5.
Figure 5. Pressure-adjustor.
Figure 6.
Figure 6. 3D surface rendering for patient 1.
Figure 7.
Figure 7. 3D surface rendering for patient 2.
Figure 8.
Figure 8. A perpendicular scan plan to the vessel flow direction (RMCA) in the 3D surface rendering and the phase contrast magnetic resonance images acquired using the scan plan.
Figure 9.
Figure 9. Flow waveform at ascending aorta measured from qMRA for patient 1.
Figure 10.
Figure 10. Flow waveform at ascending aorta measured from qMRA for patient 2.
Figure 11.
Figure 11. Pressure waveforms: catheter-transducer vs. simulation for patient 1.
Figure 12.
Figure 12. Pressure waveforms: catheter-transducer vs. simulation for patient 2.
Figure 13.
Figure 13. Vessel flows measured by qMRA vs. proposed model at baseline for patient 1.
Figure 14.
Figure 14. Vessel flows measured by qMRA vs. proposed model at baseline for patient 2.

Tables

Table 1. Primary and Secondary Vessels and Sector Flow of Enhanced Sector Model
 
SectorPrimarySecondarySector flow
LECLECALOALCCA - LICA
RECRECAROARCCA - RICA
BBA, RPCA P2, LPCA P2BA - LPCA P2 - RPCA P2
VLVA, RVA, BALVA + RVA -BA
LMCLMCA M1Anastomose between LMC and LAC Anastomose between LMC and LPCLMCA M1
RMCRMCA M1Anastomose between RMC and RAC Anastomose between RMC and RPCRMCA M1
LACLACA A2Anastomose between LAC and LMCLACA A2
RACRACA A2Anastomose between RAC and RMCRACA A2
LPCLPCA P2Anastomose between LPC and LMCLPCA P2
RPCRPCA P2Anastomose between RPC and RMCRPCA P2
LSUBLSALSA
RSUBRSARSA
ABDDADA

 

Table 2. Nominal Values of Stiffness in Major Arteries
 
ArteryStiffnessArteryStiffnessArteryStiffness
RCCA5.25LCCA5.25ACOM11.15
RICA11.15LICA11.15AA1.969
RVA7.58LVA7.58BA15.82
RMCA-M115.82LMCA-M115.82DA1.969
RACA-A111.15LACA-A111.15LSUB15.75
RACA-A215.82LACA-A215.82RSUB15.75
RPCA-P215.82LPCA-P215.82LPCOM15.82
RPCA-P115.82LPCA-P115.82RPCOM15.82
RACA-A315.82LACA-A315.82
RPCA-P315.82LPCA-P315.82

 

Table 3. Diameters (cm) and Flows (mL/min) of Major Arteries Measured by qMRA for Patient 1
 
ArteryDiameterFlowArteryDiameterFlow
LCCA5.8339RCCA5.3312
LICA4.6261RICA4.9299
LVA3.8100RVA3.366
LMCA-M13.3154RMCA-M12.6133
LACA-A12.789RACA-A12.575
LACA-A22.469RACA-A22.467
LPCA-P2256RPCA-P22.568
LPCOM0N/ARPCOM1.3-8
BA3.3139ACOM1.4N/A
AA26.63,935DA18.82,376
LSUB4120RSUB4160

 

Table 4. Diameters (cm) and Flows (mL/min) of Major Arteries Measured by qMRA for Patient 2
 
ArteryDiameterFlowArteryDiameterFlow
LCCA6.8340RCCA6.9428
LICA5.1217RICA5.2286
LVA4.5105RVA4.2102
LMCA-M12.9137RMCA-M13.2120
LACA-A10.940RACA-A12.5113
LACA-A22.366RACA-A22.480
LPCA-P22.660RPCA-P22.754
LPCOM0N/ARPCOM1.5-5
BA4.2170ACOM2.1N/A
AA32.64,298DA261,587
LSUB6.6204RSUB8.9245

 

Table 5. Sector Flows (mL/min) Between Measurement From qMRA and Proposed Model for Patient 1
 
SectorqMRAProposedChange %SectorqMRAProposedChange %
RMC1441430%LMC1671660%
REC14140%LEC84840%
RAC7374-1%LAC7575-1%
RPC74723%LPC61610%
V29283%B1616-1%
RSUB173177-2%LSUB1301291%
ABD2,572*2,4973%

 

Table 6. Sector Flows (mL/min) Between Measurement From qMRA and Proposed Model for Patient 2
 
SectorqMRAProposedChange %SectorqMRAProposedChange %
LMC137138-1%RMC1201173%
LEC1231240%REC1421392%
LAC66643%RAC8081-1%
LPC6060-1%RPC54531%
B56551%V37362%
LSUB204206-1%RSUB245246-1%
ABD2,974*2,9371%

 

Table 7. The Balloon Occlusion Simulation for Patient 1 and Patient 2
 
Patient 1Patient 2
IpsilatContralatIpsilatContralat
FlowPressureFlowPressureFlowPressureFlowPressure
Baseline
  MCA-M11558113481138109117108
  ACA-A3687667766410181101
  PCA-P2557767786010753107
Occlusion
  MCA-M114375129787665116108
  ACA-A3647263726310080100
  PCA-P2557766786010753107
Change %
  MCA-M1-8%-7%-3%-3%-45%-40%-1%0%
  ACA-A3-6%-5%-6%-5%-2%-1%-1%-1%
  PCA-P2-1%0%-1%-1%0%0%0%0%