Automated quantification of carotid artery stenosis on contrast-enhanced MRA data using a deformable vascular tube model.

Division of Image Processing, Department of Radiology, Leiden University Medical Center, Albinusdreef 2, 2333 ZA, Leiden, The Netherlands.
The international journal of cardiovascular imaging (Impact Factor: 2.15). 12/2011; 28(6):1513-24. DOI: 10.1007/s10554-011-9988-x
Source: PubMed

ABSTRACT 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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    ABSTRACT: PURPOSE: Currently, a multi-contrast protocol, including a combination of five MR-sequences is used as reference standard for morphologic imaging and quantitative measurements of the carotid artery vessel wall. The purpose of this study is to investigate the scan-rescan reproducibility together with intra- and inter-observer reproducibility of each of the five MR-sequences. METHODS: Twenty healthy volunteers (55% male, mean age=26 years) underwent repeated MR-examinations (3T-Philips-MRI) of the left carotid artery vessel wall with five sequences; T1-TFE, T2-TSE, PD-TSE, T1-TSE and 3D TOF. A standard phased-array coil with two flexible elements of 14cm×17cm was used to obtain nine transverse imaging sections of the left carotid artery with identical in-plane resolution (0.46mm×0.46mm). Reproducibility analysis was performed in 3 slices of the common carotid artery for all sequences. RESULTS: For, scan-rescan reproducibility, intra class correlation coefficients (ICC) were excellent for all sequences and ranged from 0.79 to 0.95. The intra-observer ICC ranged from 0.89 to 0.98 and the inter-observer ICC ranged from 0.84 to 0.96, for both lumen and vessel wall assessment. CONCLUSIONS: By high field MR imaging, vessel wall and lumen area of the carotid artery can be assessed with excellent scan-rescan, intra- and inter-observer reproducibility for all five sequences.
    European journal of radiology 12/2012; · 2.65 Impact Factor

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