Analysis of Intracranial Aneurysm Detection using Time-based Parametric Color-Coded Cerebral Angiogram Vs. Conventional Digital Subtraction Angiography

Achmad Adam,Muhammad Zafrullah Arifin,Beni Rio Hermanto,Wargian Hadisaputra,Ahmad Faried

doi:10.15562/ijn.v1i1.1

Abstract

Introduction: The worldwide prevalence of intracranial aneurysms is estimated to be 5-10%; approximately 10-12 million people are affected by intracranial aneurysms in the United States (US), and they are considered a major problem in public health.The manual interpretation of intracranial aneurysms based on visual examinations and direct observation of medical imaging techniques such as computed tomography (CT) scans, magnetic resonance imaging (MRI), or any of the digital subtraction angiography (DSA), are still presented in monochrome form, and it takes time to interpret the medical images.Methods: Alternative methods are in development that would allow for detection of intracranial aneurysms using open source MATLAB software. This method is a way to observe the aneurysm using the 2 dimensional (2D) DSA data based on the calculations of time to peak (TTP) and time duration (TD) of the contrast agent flow in the blood vessel in order to capture the aneurysm and visualize it using a color system based on a specific index.Results: In this study, the color changes of the DSA data that were processed using open source MATLAB software were found in 24 cases (88.9%) and only 3 cases (11.1%) did not show any color changes. Based on Spearman's correlation test, there was a significant correlation between the size of the high dome, dome-neck ratio, and the aspect ratio (p <0.01) on the color changes of data that were processed using DSA MATLAB software.Conclusion: The modification methods that capture color changes in different blood vessels are expected to be able to assist clinicians in the detection of intracranial aneurysms more quickly and precisely and are also highly dependent on the subjectivity of the observer; this method is a way to help neurosurgeons come up with new approaches for the management of aneurysms. Key Words: Intracranial aneurysm, DSA, MATLAB software, color changes

Highlights

The worldwide prevalence of intracranial aneurysms is estimated to be 5-10%; approximately 10-12 million people are affected by intracranial aneurysms in the United States (US) and they are considered a major problem in public health
The target population consisted of patients with intracranial aneurysms with saccular type whom confirmed by digital subtraction angiography (DSA) from January 1 to December 31, 2016; 27 patients that were admitted to Dr Hasan Sadikin Hospital, Bandung, Indonesia and they were recruited from a satellite hospital
Abnormal types of blood vessels, such as atherosclerotic vessels, produced a turbulent flow compared to the normal vessel that produced a streamlined flow; this is known as Reynolds Number (Re),[6] with the normal human blood flow at 37 it is Re = ῡ.D/0.027.7 The calculation of the time to peak (TTP) value was based on the pixel intensity of minimum intensity projection (MIP) images (Figure 1A-1C) and for time duration (TD), it was based on the number of frames when the pixel intensity falls below the threshold

Summary

Introduction

The worldwide prevalence of intracranial aneurysms is estimated to be 5-10%; approximately 10-12 million people are affected by intracranial aneurysms in the United States (US) and they are considered a major problem in public health. Methods: Alternative method is still being developed, allowing detection of intracranial aneurysms using open source MATLAB software This method is a way to observe the aneurysm using the 2 dimensional (2D) DSA data based on the calculations of time to peak (TTP) and time duration (TD) of the contrast agent flow in the blood vessel in order to capture the aneurysm and visualize it using a color system based on a specific index. Approximately around 10-12 million people are affected by intracranial aneurysms in the United States (US), as there group are the majority caused problem in public health point of view.[1] Patients with no history of trauma, the intracranial aneurysm is a major cause of subarachnoid bleeding (SAB), which accounts for approximately 85% of cases.[2] SAB due to intracranial aneurysms account for approximately 3-11% of overall stroke incidences and 5% of stroke deaths. Based on the global literature, when the number of events is adjusted to Indonesia's population of 250 million, SAB will be diagnosed in more than 20,000 cases per year on a national scale.[4]

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Results

Conclusion