Noninvasive assessment of cerebral artery stenoses from anatomic computed tomography angiography

Area of Science:

• Cardiovascular imaging
• Medical diagnostics
• Computational fluid dynamics

Background:

• Trans-stenotic pressure gradient (TSPG) and fractional flow reserve (FFR) are established hemodynamic measures for assessing arterial stenosis severity.
• Current invasive methods for TSPG and FFR are limited by invasiveness and cost.
• Noninvasive FFR assessment from CT angiography is validated for coronary arteries.

Purpose of the Study:

• To explore the noninvasive assessment of cerebral artery stenoses using CT angiography.
• To adapt and test a computational workflow for noninvasive TSPG and FFR in cerebral arteries.
• To evaluate the feasibility of transplanting noninvasive functional diagnosis to cerebral vasculature.

Main Methods:

• A case study of a 65-year-old woman with symptomatic cerebral artery stenoses.
• Utilized clinical symptoms, transcranial Doppler ultrasound, and CT angiography for diagnosis.
• Applied a computational workflow for noninvasive TSPG and FFR analysis.

Main Results:

• Demonstrated cerebral artery stenoses through multimodal diagnostic imaging.
• Successfully applied a computational workflow for noninvasive hemodynamic assessment in cerebral arteries.
• Pioneered the noninvasive functional diagnosis of cerebral artery stenosis.

Conclusions:

• Noninvasive hemodynamic assessment of cerebral artery stenosis is feasible.
• CT angiography-based computational analysis can provide functional insights into cerebral stenoses.
• This approach holds potential for improved diagnosis and management of cerebrovascular disease.