Measuring Tortuosity of the Intracerebral Vasculature from MRA Images

Elizabeth Bullitt, Guido Gerig, Stephen M. Pizer, Weili Lin, Stephen R. Aylward

    Research output: Contribution to journalArticlepeer-review


    The clinical recognition of abnormal vascular tortuosity, or excessive bending, twisting, and winding, is important to the diagnosis of many diseases. Automated detection and quantitation of abnormal vascular tortuosity from three-dimensional (3-D) medical image data would, therefore, be of value. However, previous research has centered primarily upon two-dimensional (2-D) analysis of the special subset of vessels whose paths are normally close to straight. This report provides the first 3-D tortuosity analysis of clusters of vessels within the normally tortuous intracerebral circulation. We define three different clinical patterns of abnormal tortuosity. We extend into 3-D two tortuosity metrics previously reported as useful in analyzing 2-D images and describe a new metric that incorporates counts of minima of total curvature. We extract vessels from MRA data, map corresponding anatomical regions between sets of normal patients and patients with known pathology, and evaluate the three tortuosity metrics for ability to detect each type of abnormality within the region of interest. We conclude that the new tortuosity metric appears to be the most effective in detecting several types of abnormalities. However, one of the other metrics, based on a sum of curvature magnitudes, may be more effective in recognizing tightly coiled, "corkscrew" vessels associated with malignant tumors.

    Original languageEnglish (US)
    Pages (from-to)1163-1171
    Number of pages9
    JournalIEEE Transactions on Medical Imaging
    Issue number9
    StatePublished - Sep 2003


    • Blood vessels
    • MRA
    • Segmentation
    • Tortuosity

    ASJC Scopus subject areas

    • Software
    • Radiological and Ultrasound Technology
    • Computer Science Applications
    • Electrical and Electronic Engineering


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