{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T17:05:18Z","timestamp":1788973518563,"version":"build-2803163510"},"reference-count":34,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2021,8,5]],"date-time":"2021-08-05T00:00:00Z","timestamp":1628121600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000923","name":"Australian Research Council","doi-asserted-by":"publisher","award":["DP200101970"],"award-info":[{"award-number":["DP200101970"]}],"id":[{"id":"10.13039\/501100000923","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000923","name":"Australian Research Council","doi-asserted-by":"publisher","award":["DP200103492"],"award-info":[{"award-number":["DP200103492"]}],"id":[{"id":"10.13039\/501100000923","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Physiol."],"abstract":"<jats:p>Digital subtraction angiography (DSA) is a fluoroscopic technique used extensively in interventional radiology for visualizing blood vessels. It has also been used to evaluate blood perfusion. However, the perfusion obtained in previous techniques was extracted from signal intensity rather than by the transport of contrast material (CM) through blood flow. The main aim of this study is to evaluate the morphological effects on the hemodynamics and the CM concentration in the middle cerebral artery (MCA) stenosis. We proposed a quantitative parameter, i.e., contrast material remaining time (CMRT), to describe the variation in the transport of CM over time. Computational fluid dynamics simulations were performed on both reconstructive synthetic and patient-derived models. In the synthetic models, we evaluated the variation of flow patterns and the transport of CM with different degrees of stenosis and the location of the lesion. It was found that an increase in the degree of stenosis (from 30 to 80%) resulted in a significant increase in CMRT at the anterior cerebral artery (ACA) outlet (<jats:italic>p<\/jats:italic> = 0.0238) and a significant decrease in CMRT at the MCA outlet (<jats:italic>p<\/jats:italic> = 0.012). The patient-derived models were reconstructed from the pre- and post-interventional DSA images of a patient with MCA stenosis. Both blood flow velocity and CMRT increased at the ACA outlet but decreased at the MCA outlet. The perfusion analysis demonstrated that the perfusion function was improved after interventional surgery. In conclusion, changes in stenotic degree at MCA may lead to apparent differences in the hemodynamic distribution and the transport of CM. CMRT could be a quantitative indicator to evaluate the changes in blood perfusion after the intervention for MCA stenosis.<\/jats:p>","DOI":"10.3389\/fphys.2021.716173","type":"journal-article","created":{"date-parts":[[2021,8,5]],"date-time":"2021-08-05T09:47:42Z","timestamp":1628156862000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":6,"title":["Digital Subtraction Angiography Contrast Material Transport as a Direct Assessment for Blood Perfusion of Middle Cerebral Artery Stenosis"],"prefix":"10.3389","volume":"12","author":[{"given":"Yun-Hao","family":"Lu","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yan","family":"Cai","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yi","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rui","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhi-Yong","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2021,8,5]]},"reference":[{"key":"B1","first-page":"764","article-title":"Length of the anterior cerebral artery (ACA) on MRI angiograms","volume":"6","author":"Aggarwal","year":"2012","journal-title":"J. Clin. Diagnostic Res"},{"key":"B2","doi-asserted-by":"publisher","first-page":"288","DOI":"10.1016\/j.amjcard.2011.08.042","article-title":"Effects of physical activity on cardiovascular disease","volume":"109","author":"Ahmed","year":"2012","journal-title":"Am. J. Cardiol"},{"key":"B3","doi-asserted-by":"publisher","first-page":"2099","DOI":"10.1016\/j.jstrokecerebrovasdis.2016.06.005","article-title":"Arterial spin-labeling magnetic resonance perfusion imaging with dual postlabeling delay in internal carotid artery steno-occlusion: validation with digital subtraction angiography","volume":"25","author":"Akiyama","year":"2016","journal-title":"J. Stroke Cerebrovasc. Dis"},{"key":"B4","doi-asserted-by":"publisher","first-page":"317","DOI":"10.3174\/ajnr.A1797","article-title":"Rest versus exercise hemodynamics for middle cerebral artery aneurysms: a computational study","volume":"31","author":"Bowker","year":"2010","journal-title":"Am. J. Neuroradiol"},{"key":"B5","doi-asserted-by":"publisher","first-page":"432","DOI":"10.3340\/jkns.2015.57.6.432","article-title":"Quantitative digital subtraction angiography in pediatric moyamoya disease","volume":"57","author":"Cheon","year":"2015","journal-title":"J. Korean Neurosurg. Soc"},{"key":"B6","doi-asserted-by":"publisher","first-page":"43","DOI":"10.1136\/neurintsurg-2012-010613","article-title":"Is FlowMap, a novel tool to examine blood flow changes induced by flow diverter stent treatment: Initial experiences with pipeline cases","volume":"5","author":"Chien","year":"2013","journal-title":"J. Neurointerv. Surg"},{"key":"B7","doi-asserted-by":"publisher","first-page":"3248","DOI":"10.1161\/STROKEAHA.108.520593","article-title":"Territorial arterial spin labeling in the assessment of collateral circulation: comparison with digital subtraction angiography","volume":"39","author":"Chng","year":"2008","journal-title":"Stroke"},{"key":"B8","doi-asserted-by":"publisher","first-page":"536","DOI":"10.1136\/neurintsurg-2015-011671","article-title":"Vascular geometry of the extracranial carotid arteries: an analysis of length, diameter, and tortuosity","volume":"8","author":"Choudhry","year":"2016","journal-title":"J. Neurointerv. Surg"},{"key":"B9","doi-asserted-by":"publisher","first-page":"139","DOI":"10.1111\/j.1552-6569.2006.00024.x","article-title":"Comparison of asymmetry in cerebral blood flow between brain hemispheres using digital subtraction angiography","volume":"16","author":"Divani","year":"2006","journal-title":"J. Neuroimaging"},{"key":"B10","doi-asserted-by":"publisher","first-page":"1219","DOI":"10.1016\/j.avsg.2013.12.008","article-title":"CT angiography-derived duplex ultrasound velocity criteria in patients with carotid artery stenosis","volume":"28","author":"Doyle","year":"2014","journal-title":"Ann. Vasc. Surg"},{"key":"B11","doi-asserted-by":"publisher","first-page":"333","DOI":"10.1093\/bja\/aes497","article-title":"Misplaced central venous catheters: Applied anatomy and practical management","volume":"110","author":"Gibson","year":"2013","journal-title":"Br. J. Anaesth"},{"key":"B12","doi-asserted-by":"publisher","first-page":"332","DOI":"10.1038\/s41569-018-0005-0","article-title":"Interventions for lower extremity peripheral artery disease","volume":"15","author":"Hiramoto","year":"2018","journal-title":"Nat. Rev. Cardiol"},{"key":"B13","doi-asserted-by":"publisher","first-page":"H639","DOI":"10.1152\/ajpheart.00464.2015","article-title":"Morphometric and hemodynamic analysis of atherosclerotic progression in human carotid artery bifurcations","volume":"310","author":"Huang","year":"2016","journal-title":"Am. J. Physiol."},{"key":"B14","doi-asserted-by":"publisher","first-page":"90380L","DOI":"10.1117\/12.2041347","article-title":"Effect of injection technique on temporal parametric imaging derived from digital subtraction angiography in patient specific phantoms","volume":"9038","author":"Ionita","year":"2014","journal-title":"Proc. SPIE Int. Soc. Opt. Eng."},{"key":"B15","unstructured":"JonesZ. R.\n          The Effect of Artery Bifurcation Angles on Fluid Flow and Wall Shear Stress in the Middle Cerebral Artery2014"},{"key":"B16","doi-asserted-by":"publisher","first-page":"796","DOI":"10.1097\/RLI.0b013e31822b1272","article-title":"Changes of renal water diffusion coefficient after application of iodinated contrast agents: effect of viscosity","volume":"46","author":"Jost","year":"2011","journal-title":"Invest. Radiol"},{"key":"B17","doi-asserted-by":"publisher","first-page":"541","DOI":"10.1177\/0271678X16631149","article-title":"Measurement of cerebral blood flow using phase contrast magnetic resonance imaging and duplex ultrasonography","volume":"37","author":"Khan","year":"2017","journal-title":"J. Cereb. Blood Flow Metab"},{"key":"B18","doi-asserted-by":"publisher","first-page":"3018","DOI":"10.1016\/j.jbiomech.2014.06.042","article-title":"Curvature effect on hemodynamic conditions at the inner bend of the carotid siphon and its relation to aneurysm formation","volume":"47","author":"Lauric","year":"2014","journal-title":"J. Biomech"},{"key":"B19","doi-asserted-by":"publisher","first-page":"752","DOI":"10.1002\/ana.25456","article-title":"Hemodynamics and stroke risk in intracranial atherosclerotic disease","volume":"85","author":"Leng","year":"2019","journal-title":"Ann. Neurol"},{"key":"B20","doi-asserted-by":"publisher","first-page":"122","DOI":"10.4103\/0975-3583.70905","article-title":"Diagnosis and surgical treatment of carotid body tumor: a report of 18 cases","volume":"1","author":"Ma","year":"2010","journal-title":"J. Cardiovasc. Dis. Res"},{"key":"B21","first-page":"877","article-title":"MR angiography of dural arteriovenous fistulas: Diagnosis and follow-up after treatment using a time-resolved 3D contrast-enhanced technique","volume":"28","author":"Meckel","year":"2007","journal-title":"Am. J. Neuroradiol"},{"key":"B22","doi-asserted-by":"publisher","first-page":"1121","DOI":"10.1016\/j.jvs.2018.08.152","article-title":"Comparison of outcomes in women and men following carotid interventions in the Washington state's Vascular Interventional Surgical Care and Outcomes Assessment Program","volume":"69","author":"Nevidomskyte","year":"2019","journal-title":"J. Vasc. Surg"},{"key":"B23","doi-asserted-by":"publisher","first-page":"42","DOI":"10.1111\/ijlh.12426","article-title":"Comparison between different D-Dimer cutoff values to assess the individual risk of recurrent venous thromboembolism: analysis of results obtained in the DULCIS study","volume":"38","author":"Palareti","year":"2016","journal-title":"Int. J. Lab. Hematol"},{"key":"B24","doi-asserted-by":"publisher","first-page":"e43","DOI":"10.1097\/MCA.0000000000000219","article-title":"Advances in three-dimensional coronary imaging and computational fluid dynamics: Is virtual fractional flow reserve more than just a pretty picture?","volume":"26","author":"Poon","year":"2015","journal-title":"Coron. Artery Dis"},{"key":"B25","doi-asserted-by":"publisher","first-page":"371","DOI":"10.1136\/neurintsurg-2012-010314","article-title":"Cerebrovascular geometry in the anterior circulation: an analysis of diameter, length and the vessel taper","volume":"5","author":"Rai","year":"2013","journal-title":"J. Neurointerv. Surg"},{"key":"B26","doi-asserted-by":"publisher","first-page":"2010","DOI":"10.1161\/STROKEAHA.114.005731","article-title":"Length of occlusion predicts recanalization and outcome after intravenous thrombolysis in middle cerebral artery stroke","volume":"45","author":"Rohan","year":"2014","journal-title":"Stroke"},{"key":"B27","doi-asserted-by":"publisher","first-page":"1672","DOI":"10.1161\/01.STR.31.7.1672","article-title":"MRI measures of middle cerebral artery diameter in conscious humans during simulated orthostasis","volume":"31","author":"Serrador","year":"2000","journal-title":"Stroke"},{"key":"B28","doi-asserted-by":"publisher","first-page":"342","DOI":"10.1002\/(SICI)1522-2586(199902)9:2<342::AID-JMRI29>3.0.CO;2-B","article-title":"CBF and CBV measurements by USPIO bolus tracking: reproducibility and comparison with Gd-based values","volume":"9","author":"Simonsen","year":"1999","journal-title":"J. Magn. Reson. Imaging"},{"key":"B29","doi-asserted-by":"publisher","first-page":"231","DOI":"10.1002\/1098-2353(2000)13:4<231::AID-CA1>3.0.CO;2-T","article-title":"Anatomic variations of anterior cerebral artery cortical branches","volume":"13","author":"Stefani","year":"2000","journal-title":"Clin. Anat"},{"key":"B30","doi-asserted-by":"publisher","first-page":"919","DOI":"10.3174\/ajnr.A2020","article-title":"Parametric color coding of digital subtraction angiography","volume":"31","author":"Strother","year":"2010","journal-title":"Am. J. Neuroradiol"},{"key":"B31","doi-asserted-by":"publisher","first-page":"261","DOI":"10.3171\/jns.1985.62.2.0261","article-title":"The perforating branches of the middle cerebral artery. A microanatomical study","volume":"62","author":"Umansky","year":"1985","journal-title":"J. Neurosurg"},{"key":"B32","doi-asserted-by":"publisher","first-page":"e009705","DOI":"10.1161\/JAHA.118.009705","article-title":"Differential features of culprit intracranial atherosclerotic lesions: a whole-brain vessel wall imaging study in patients with acute ischemic stroke","volume":"7","author":"Wu","year":"2018","journal-title":"J. Am. Heart Assoc"},{"key":"B33","doi-asserted-by":"publisher","first-page":"285","DOI":"10.1016\/j.nic.2011.01.003","article-title":"Arterial spin label imaging of acute ischemic stroke and transient ischemic attack","volume":"21","author":"Zaharchuk","year":"2011","journal-title":"Neuroimaging Clin. N. Am"},{"key":"B34","doi-asserted-by":"publisher","first-page":"203","DOI":"10.1038\/s41569-018-0119-4","article-title":"Epidemiology of cardiovascular disease in China: current features and implications","volume":"16","author":"Zhao","year":"2019","journal-title":"Nat. Rev. Cardiol"}],"container-title":["Frontiers in Physiology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fphys.2021.716173\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,8,5]],"date-time":"2021-08-05T09:47:55Z","timestamp":1628156875000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fphys.2021.716173\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,8,5]]},"references-count":34,"alternative-id":["10.3389\/fphys.2021.716173"],"URL":"https:\/\/doi.org\/10.3389\/fphys.2021.716173","relation":{},"ISSN":["1664-042X"],"issn-type":[{"value":"1664-042X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,8,5]]},"article-number":"716173"}}