A technique is presented for segmentation and quantification of stenosed internal carotid arteries in three-dimensional contrast-enhanced magnetic resonance angiography. Segmentation with sub-voxel accuracy of the internal carotid arteries (ICAs) has been achieved via level-set techniques in which the central axis serves as initialization. The central axis is determined with minmal user-interaction, viz. two user-defined points. Quantification is performed by measuring the cross-sectional area in the stenosis and at a reference segment in planes perpendicular to the central axis. The technique was applied to 52 ICAs. It is demonstrated that the method's reproducibility is better than the intra-observer agreement. Furthermore, the agreement between the presented method and the observers is better than the inter-observer agreement.
Blood pool agents (BPAs) for contrast-enhanced magnetic resonance angiography (CE-MRA) allow prolonged imaging times for higher contrast and resolution by imaging during the steady-state when the contrast agent is distributed through the complete vascular system. However, simultaneous venous and arterial enhancement hampers interpretation. It is shown that arterial and venous segmentation in this equilibrium phase can be achieved if the central arterial axis (CAA) and central venous axis (CVA) are known. Since the CAA can not straightforwardly be obtained from the steady-state data, images acquired during the first-pass of the contrast agent can be utilized to determine the CAA with minimal user initialization. Utilizing the CAA to provide a rough arterial segmentation, the CVA can subsequently be determined from the steady-state dataset. The final segmentations of the arteries and veins are achieved by simultaneously evolving two level-sets in the steady-state dataset starting from the CAA and CVA.
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