Four-Dimensional Vascular Tree Reconstruction Using Moving Grid Deformation

Rationale and Objectives: Thinned perforator flaps have been widely used in plastic surgery for greater survivability and decreased morbidity. However, quantitative analysis of three-dimensional (3D) blood flow direction and location has not been examined yet. Such information will benefit and guide the surgical thinning and dissection process. Toward this goal, this study was performed for 3D vascular tree reconstruction with the incorporation of temporal contrast-agent propagation information (three spatial dimensions plus one temporal dimension; ie, 4D). Materials and Methods: A novel computational framework by adopting a moving grid deformation method is presented. To take advantage of temporal information of the bolus propagating, a sequential segmentation procedure is proposed. Moreover, the temporal evolution of the vascular tree (4D vascular tree) is reconstructed during the procedure. Results: Eight anterolateral thigh perforator flaps from eight cadavers were used for this study. The age range is 60-80 years old and the gender includes four males and four females. The 3D nature of the vascular structure and 4D vascular tree evolving process are showed in comparison with maximum intensity projection images. Conclusion: The proposed computational framework demonstrates effectiveness in the modeling of 4D vascular tree. Furthermore, it reveals the ability to detect small vessel tree structures that are beyond the limit of image resolution.