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Building Three-Dimensional Intracranial Aneurysm Models from 3D-TOF MRA: a Validation Study

  • Turker Acar
  • Asli Beril Karakas
  • Mehmet Asim Ozer
  • Ali Murat Koc
  • Figen GovsaEmail author
Original Paper
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Abstract

To create realistic three-dimensional (3D) vascular models from 3D time-of-flight magnetic resonance angiography (3D-TOF MRA) of an intracranial aneurysm (IA). Thirty-two IAs in 31 patients were printed using 3D-TOF MRA source images from polylactic acid (PLA) raw material. Two observers measured the maximum IA diameter at the longest width twice separately. A total mean of four measurements as well as each observer’s individual average MRA lengths were calculated. After printing, 3D-printed anatomic models (PAM) underwent computed tomography (CT) acquisition and each observer measured them using the same algorithm as applied to MRA. Inter- and intra-observer consistency for the MRA and CT measurements were analyzed using the intraclass correlation coefficient (ICC) and a Bland-Altman plot. The mean maximum aneurysm diameter obtained from four MRA evaluations was 8.49 mm, whereas it was 8.83 mm according to the CT 3D PAM measurement. The Wilcoxon test revealed slightly larger mean CT 3D PAM diameters than the MRA measurements. The Spearman’s correlation test yielded a positive correlation between MRA and CT lengths of 3D PAMs. Inter and intra-observer consistency were high in consecutive MRA and CT measurements. According to Bland-Altman analyses, the aneurysmal dimensions obtained from CT were higher for observer 1 and observer 2 (a mean of 0.32 mm and 0.35 mm, respectively) compared to the MRA measurements. CT dimensions were slightly overestimated compared to MRA measurements of the created models. We believe the discrepancy may be related to the Laplacian algorithm applied for surface smoothing and the high slice thickness selection that was used. However, ICC provided high consistency and reproducibility in our cohort. Therefore, it is technically possible to produce 3D intracranial aneurysm models from 3D-TOF MRA images.

Keywords

3D-TOF magnetic resonance angiography Intracranial aneurysm Three-dimensional printing 

Notes

Author Contributions

Study design: TA, MAO

Data assembly: ABK

Data analysis: MAO, AMK

Final approval of manuscript: TA, FG

Compliance with Ethical Standards

Conflict of Interest

The authors declare that they have no conflict of interest.

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Copyright information

© Society for Imaging Informatics in Medicine 2019

Authors and Affiliations

  1. 1.Department of RadiologyUniversity of Health Sciences Bozyaka Education and Training HospitalIzmirTurkey
  2. 2.Department of Anatomy Digital Imaging and 3D Modelling Laboratory, Faculty of MedicineEge University School of MedicineIzmirTurkey
  3. 3.Department of RadiologyUniversity of Ottawa Faculty of Medicine and The Ottawa Hospital Research, InstituteOttawaCanada

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