Article Figures & Data
Figures
- Fig 1.
Screenshot of the evaluation form used in the evaluation of the 4D-DSA reconstructions.
- Fig 2.
A comparison of conventional 3D-DSA (upper row) with different timeframes from a 4D-DSA reconstruction (lower row). The projections of the 2 image types are identical. The 3D-DSA images allow viewing from any desired angle; however, in this case because of the vascular overlap, it is impossible to clearly see the relationship of the small aneurysm (yellow circle) to its parent artery. Because the 4D images allow viewing not only from any desired angle but also at any time during the passage of a contrast bolus through the vasculature, the early timeframes of the 4D images allow clear visualization of these relationships.
- Fig 3.
A, 3D-DSA of an AVM supplied by 2 branches of the right MCA. Despite the excellent image quality, the image is a composite of all of the 2D projections used in the reconstruction. The overlap of vascular components in the nidus precludes identification of intranidal aneurysms, the direct AVF, or venous outflow stenosis. B, Two views of early timeframes from a 4D-DSA reconstruction of the AVM shown in part A. The projections for this reconstruction are obtained at 30 frames per second. The number of each timeframe is shown beside each image. The angioarchitecture of the nidus can be clearly seen. The 4D-DSA images may be viewed from any desired angle at any time in the bolus passage.
Tables
- Table 1:
Results of the 3 evaluators decisions regarding the presence of an abnormality on the 4D studies
4D Method Evaluator 1 2 3 No. (% Correct) No. (% Correct) No. (% Correct) Definitely yes 17 (100) 15 (100) 18 (100) Probably yes 2 (50) 3 (100) 1 (0) Unsure 0 (NaN) 1 (0) 0 (NaN) Probably no 2 (100) 0 (NaN) 0 (NaN) Definitely no 5 (100) 7 (100) 7 (100) Note:—NaN indicates not a number.
- Table 2:
Results of the 3 evaluator's decisions when results were consolidated into responses of yes, unsure, and no
4D Method Evaluator 1 2 3 No. (% Correct) No. (% Correct) No. (% Correct) Yes 19 (95) 18 (100) 19 (95) Unsure 0 (NaN) 1 (0) 0 (NaN) No 7 (100) 7 (100) 7 (100) Note:—NaN indicates not a number.
4D Method Evaluator Consensus 1 2 3 True Yes True No True Yes True No True Yes True No True Yes True No Yes 18 1 18 0 18 1 18 0 Unsure 0 0 0 1 0 0 0 0 No 0 7 0 7 0 7 0 8 ↵a Data are frequencies.
- Table 4:
Evaluator's sensitivity, specificity, positive predictive value, negative predictive value, area under the curve, and consensus results
Measurement Evaluator Consensus 1 2 3 Sensitivity 1 1 1 1 Specificity 0.875 0.875 0.875 1 PPV 0.947 0.947 0.947 1 NPV 1 1 1 1 AUC (95% CI) 0.938 (0.815–1.000) 0.938 (0.815–1.000) 0.938 (0.815–1.000) 1.000 (1.000–1.000) Note:—PPV indicates positive predictive value; NPV, negative predictive value; AUC, area under the curve.
4D Method Evaluator 1 2 3 No. No. No. Aneurysm 9 10 11 AVF 3 2 2 AVM 3 4 4 Occlusive disease–stenosis 4 3 2 ↵a There were 9 aneurysms, 6 AVMs/AVFs, 8 normal, 3 stenosis/occlusion in the study population.
- Table 6:
Summary of agreement between 4D and 2D/3D evaluations regarding type of abnormality (when there was one)a
4D:True Evaluator Consensus 1 2 3 Aneur AVF AVM OD-S None Aneur AVF AVM OD-S None Aneur AVF AVM OD-S None Aneur AVF AVM OD-S None Aneur 9 0 0 0 0 9 0 0 1 0 9 0 0 1 1 9 0 0 1 0 AVF 0 3 0 0 0 0 2 0 0 0 0 2 0 0 0 0 2 0 0 0 AVM 0 0 3 0 0 0 1 3 0 0 0 1 3 0 0 0 1 3 0 0 OD-S 0 0 0 3 1 0 0 0 2 1 0 0 0 2 0 0 0 0 2 0 None 0 0 0 0 7 0 0 0 0 7 0 0 0 0 7 0 0 0 0 8 Note:—Aneur indicates aneurysm; OD-S, occlusive disease–stenosis.
↵a Data are frequencies.
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