Detection of Cerebral Aneurysm by Performing

Thresholding-Spatial Filtering-Thresholding Operations

on Digital Subtraction Angiogram

Jubin Mitra and Abhijit Chandra

Department of Electronics & Telecommunication Engineering

Bengal Engineering and Science University, Shibpur, Howrah, India
jm61288@gmail.com,
abhijit922@yahoo.co.in

Abstract. Cerebral aneurysm (CA) has been emerging as one of the life threat-
ening diseases which have developed a deep concern amongst the neurologists
in recent years. To be specific, it shows devastating characteristic due to the
formation of abnormal bulging of artery in human brain followed by its rupture.
Therefore detection of this abnormality prior to the rupture becomes inevitably
essential to save our lives to a great extent. This paper throws enough light in
detecting cerebral aneurysm of various sizes by combining the operations of
spatial filtering and thresholding in an elegant way. A number of Digital Sub-
traction Angiogram (DSA) images, affected by cerebral aneurysm of various
magnitudes, have been taken into consideration in this connection. Finally, the
affected area has been marked with red colour to make it more prominent than
the other parts of the image.

1 Introduction
Cerebral aneurysm (CA) is a cerebrovascular disorder resulting from the localised
bulging of blood vessel. It may be of congenital type or may develop with age due to
the weakness or certain injury in the wall of the blood vessels. CA is of saccular kind
in nature located mostly at the bifurcation of the arteries, known as Circle of Willis
[1]. Cerebral Aneurysm is also known as intracranial aneurysm in many articles.
This disorder of arteries in brain may take place at various locations. Extensive
medical analysis have found that the frequent sites of occurrence of CA are Internal
Carotid Artery (30-35%), Anterior Cerebral Artery (33-34%) and Middle Cerebral
Artery (20%) [2]. Apart from having single Cerebral Aneurysm; multiple Cerebral
Aneurysm does also exist which has an occurrence probability of 0.2 to 0.4. It is more
predominant in women than in men. In USA, 10-12 billion people are affected with
cerebral aneurysm, with rupture ratio 1:10,000 people per year.
Common causes of occurrence are due to infectious disease, hypertension, smoking
and genetic abnormalities. Symptoms might range from nausea, severe headache, vi-
sion impairment, unconsciousness to no symptoms at all. If not treated at proper time,
large Cerebral Aneurysm can lead to a bigger problem known as Subarachnoid
Haemorrhage (SAH) which results due to the rupture of blood vessels [1]-[3].

N. Meghanathan et al. (Eds.): Advances in Computing & Inform. Technology, AISC 177, pp. 915–921.
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916 J. Mitra and A. Chandra

Modern treatment method for cerebral aneurysm can be divided into non-invasive and
invasive techniques. Non-invasive method includes Transcranial Doppler technique;
whereas invasive techniques like CT scan, MRI or nuclear perfusion scanning are
more popularly employed in this regard.
In recent past, few approaches were adopted by researchers towards the detection
of cerebral aneurysm with the aids of image processing techniques. Segmentation of
giant CA, composed of lumen and thrombus, has been carried out successfully by one
multi-level object detection scheme based on Lattice Boltzmann Method (LBM) [4].
Experimental results have demonstrated the fact that with the proposed method both
lumen and thrombus can be well segmented.
Another such method utilizes 2D Digital Subtraction Angiography (DSA) imaging
technique, based on the calculation of Time to Peak (TTP) and Time Duration (TD) of
flow of contrast agent in the blood vessels [5]. Combined TTP and TD algorithm was
successful in detecting medium size aneurysm. However, the algorithm has certain
weaknesses in the sense that without the help of the Multiscale Vessel Enhancement
Filtering (MVEF), the quality of vessel segmentation is bad and may cause wrong de-
tection of blood vessel segment. Moreover, the authors could not develop any suitable
approach which can be useful in detecting small size aneurysm.
Our study of focus is on the detection of cerebral aneurysms of various sizes from
2D Cerebral Angiogram. The proposed method requires much less resource and is
significantly faster than the previously proposed time based parametric technique [5].
Our approach uses simple yet elegant techniques like dual thresholding operation with
one round of smoothing filtering to extract the region of interest. The resultant image
is then superimposed over the original one to highlight and identify the aneurysm. A
number of test images have been considered into our analysis to prove the supremacy
of the proposed approach. Entire simulation work was performed by using MATLAB
7.0 software.

2 Theoretical Background
A. Cerebral Aneurysm (CA)

Aneurysm refers to a weak area in the wall of a blood vessel which results in bulging
or ballooning out of the blood vessel. Aneurysm in the brain occurs if there is any
weakened area in the wall of a blood vessel. Such an aneurysm which occurs in a
blood vessel of the brain is called cerebral aneurysm (CA) [1]-[2]. It may be present
from birth which is known as congenital aneurysm or it may be developed in later part
of life due to a variety of reasons.
Aneurysms can be classified in terms of size and shape of the bulging. Berry aneu-
rysm and giant berry aneurysm are more common in adults than children. The size of
berry aneurysm can range from a few millimeters to over a centimeter. Giant berry
aneurysms can reach well over 2 centimeters in size [2]. Amongst all aneurysms, mul-
tiple berry aneurysms are hereditary more often than other types of aneurysms. Apart
from these two, large, medium and small size aneurysms can also be observed for
many patients. The typical size of large size aneurysm is between 16 to 25 mm; whe-
reas that of medium size aneurysm can vary between 6 to 15 mm. On the other hand,