A novel MRA-based framework for the detection of changes in cerebrovascular blood pressure.

Background: High blood pressure (HBP) affects 75 million adults and is the primary or contributing cause of mortality in 410,000 adults each year in the United States. Chronic HBP leads to cerebrovascular changes and is a significant contributor for strokes, dementia, and cognitive impairment. Non-invasive measurement of changes in cerebral vasculature and blood pressure (BP) may enable physicians to optimally treat HBP patients. This manuscript describes a method to non-invasively quantify changes in cerebral vasculature and BP using Magnetic Resonance Angiography (MRA) imaging. Methods: MRA images and BP measurements were obtained from patients (n=15, M=8, F=7, Age= 49.2 ± 7.3 years) over a span of 700 days. A novel segmentation algorithm was developed to identify brain vasculature from surrounding tissue. The data was processed to calculate the vascular probability distribution function (PDF); a measure of the vascular diameters in the brain. The initial (day 0) PDF and final (day 700) PDF were used to correlate the changes in cerebral vasculature and BP. Correlation was determined by a mixed effects linear model analysis. Results: The segmentation algorithm had a 99.9% specificity and 99.7% sensitivity in identifying and delineating cerebral vasculature. The PDFs had a statistically significant correlation to BP changes below the circle of Willis (p-value = 0.0007), but not significant (p-value = 0.53) above the circle of Willis, due to smaller blood vessels. Conclusion: Changes in cerebral vasculature and pressure can be non-invasively obtained through MRA image analysis, which may be a useful tool for clinicians to optimize medical management of HBP

Vascular segmentation in three-dimensional rotational angiography based on maximum intensity projections

Three-dimensional rotational angiography (3D-RA) is a relatively new and promising technique for imaging blood vessels. In this paper, we propose a novel 3D-RA vascular segmentation algorithm, which is fully automatic and very computationally efficient, based on the maximum intensity projections (MEP) of 3D-RA images. Validation results on 13 clinical 3D-RA datasets reveal that, according to the agreement between the segmentation results and the ground truth, our method (a) outperforms both the Maximum a posteriori-expectation maximization (MAP-EM)-based method and the MAP-Markov random field (MAP-MRF)-based segmentation method, and (b) works comparably to the optimal global thresholding method. Experimental results also show that our method can successfully segment major vascular structures in 3D-RA and produce a lower false positive rate than that of the MAP-EM-based and MAP-MRF-based methods