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Fig. 3 | BioMedical Engineering OnLine

Fig. 3

From: A precision medicine framework for personalized simulation of hemodynamics in cerebrovascular disease

Fig. 3

In our visual comparison we found promising initial results for the detection of vulnerabilities by mechanistic simulations (see Table 1). In this figure, we exemplify this in two patients. Simulation results are shown on the left and DSC-imaging results are shown on the right. In the patient with a proximal common carotid occlusion on the right (upper box), no hemodynamic changes are visible in the DSC perfusion imaging maps indicative of a sufficient CoW to provide all brain areas with sufficient perfusion. The simulation shows correspondingly no areas reaching critical limits, at both normal and lowered blood pressure levels. In the patient with the right MCA stenosis (lower box), the DSC perfusion maps show delay in TPP, MTT and Tmax maps as well as a lower CBF in the right MCA area. This is in line with our simulation which shows critical pressure levels in the M2 inferior node and lowered pressure already at a normal blood pressure of 120/80. When blood pressure is lowered to 90/60, both M2 supply areas become critical in contrast to the other branches. Supply areas are color coded according to the calculated pressure (all values in mmHg: > 70 pink, < 70 yellow, < 60 orange, < 50 red)

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