Diagnostic Value of Low-Dose 256-Slice Spiral CT Angiography, MR Angiography, and 3D-DSA in Cerebral Aneurysms

Objective. To evaluate the diagnostic value of low-dose 256-slice CT angiography (CTA), MR angiography (MRA), and three dimensional-digital subtraction angiography (3D-DSA) in cerebral aneurysms. Methods. CTA, MRA, and 3D-DSA were performed in all enrolled patients to explore the diagnostic significance of the three different examinations. Results. There were 92 aneurysms confirmed during DSA and surgery in 79 patients. The diagnostic coincidence rates of DSA, CTA, and MRA were 96.7%, 89.1%, and 86%, respectively. The diagnostic coincidence rates of CTA and MRA were lower than those of DSA. The detection rate of CTA for aneurysms less than 3 mm in diameter was higher than that of MRA. Conclusion. CTA, DSA, and MRA have their own advantages and disadvantages in the diagnosis of cerebral aneurysms. They all have the diagnostic value for aneurysms.

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Circle of Willis: evaluation with spiral CT angiography, MR angiography, and conventional angiography.

Radiology ◽

10.1148/radiology.195.2.7724764 ◽

1995 ◽

Vol 195 (2) ◽

pp. 445-449 ◽

Cited By ~ 126

Author(s):

D A Katz ◽

M P Marks ◽

S A Napel ◽

P M Bracci ◽

S L Roberts

Keyword(s):

Ct Angiography ◽

Mr Angiography ◽

Spiral Ct ◽

Circle Of Willis ◽

Conventional Angiography ◽

Spiral Ct Angiography

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Automated Segmentation and Visualization of the Pulmonary Vascular Tree in Spiral CT Angiography: An Anatomy-Oriented Approach Based on Three-Dimensional Image Analysis

Journal of Computer Assisted Tomography ◽

10.1097/00004728-200107000-00014 ◽

2001 ◽

Vol 25 (4) ◽

pp. 587-597 ◽

Cited By ~ 16

Author(s):

Yoshitaka Masutani ◽

Heber MacMahon ◽

Kunio Doi

Keyword(s):

Image Analysis ◽

Ct Angiography ◽

Three Dimensional ◽

Spiral Ct ◽

Automated Segmentation ◽

Vascular Tree ◽

Dimensional Image ◽

Spiral Ct Angiography ◽

Oriented Approach

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Use of spiral computerized tomography angiography in patients with subarachnoid hemorrhage in whom subtraction angiography did not reveal cerebral aneurysms

Journal of Neurosurgery ◽

10.3171/jns.2000.92.2.0278 ◽

2000 ◽

Vol 92 (2) ◽

pp. 278-283 ◽

Cited By ~ 77

Author(s):

Hiroyuki Hashimoto ◽

Jun-Ichi Iida ◽

Yasuo Hironaka ◽

Masato Okada ◽

Toshisuke Sakaki

Keyword(s):

Subarachnoid Hemorrhage ◽

Ct Angiography ◽

Cerebral Aneurysms ◽

Spiral Ct ◽

The Other ◽

Anterior Communicating Artery ◽

Content Type ◽

Spiral Ct Angiography ◽

Spiral Computerized Tomography ◽

Fine Print

Object. Patients with subarachnoid hemorrhage (SAH) in whom angiography does not demonstrate diagnostic findings sometimes suffer recurrent disease and actually harbor undetected cerebral aneurysms. The management strategy for such cases remains controversial, but technological advances in spiral computerized tomography (CT) angiography are changing the picture. The purpose of this prospective study was to examine how spiral CT angiography can contribute to the detection of cerebral aneurysms that cannot be visualized on angiography.Methods. In 134 consecutive patients with SAH, a prospective search for the source of bleeding was performed using digital subtraction (DS) and spiral CT angiography. In 21 patients in whom initial DS angiography yielded no diagnostic findings, spiral CT angiography was performed within 3 days. Patients in whom CT angiography provided no diagnostic results underwent second and third DS angiography sessions after approximately 2 weeks and 6 months, respectively.Six patients with perimesencephalic SAH were included in the 21 cases. Six of the other 15 patients had small cerebral aneurysms detectable by spiral CT angiography, five involving the anterior communicating artery and one the middle cerebral artery. Two patients in whom initial angiograms did not demonstrate diagnostic findings proved to have a ruptured dissecting aneurysm of the vertebral artery; in one case this was revealed at autopsy and in the other during the second DS angiography session. A third DS angiography session revealed no diagnostic results in 13 patients.Conclusions. Spiral CT angiography was useful in the detection of cerebral aneurysms in patients with SAH in whom angiography revealed no diagnostic findings. Anterior communicating artery aneurysms are generally well hidden in these types of SAH cases. A repeated angiography session was warranted in patients with nonperimesencephalic SAH and in whom initial angiography revealed no diagnostic findings, although a third session was thought to be superfluous.

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Three-dimensional spiral CT angiography in the detection of cerebral aneurysm

Acta Radiologica ◽

10.1080/02841859809172186 ◽

1998 ◽

Vol 39 (3) ◽

pp. 233-238 ◽

Cited By ~ 20

Author(s):

M. Strayle-Batra ◽

M. Skalej ◽

A. K. Wakhloo ◽

U. Ernemann ◽

R. Klier ◽

...

Keyword(s):

3D Reconstruction ◽

Ct Angiography ◽

Internal Carotid ◽

Three Dimensional ◽

Spatial Relationship ◽

Spiral Ct ◽

Posterior Communicating Artery ◽

Close Spatial Relationship ◽

Spiral Ct Angiography ◽

Acute Subarachnoid Hemorrhage

Purpose: The value of CT angiography in the detection and evaluation of aneurysms was compared to digital subtraction angiography (DSA) Material and Methods: Seventeen patients with acute subarachnoid hemorrhage (SAH) or with known or suspected aneurysm were investigated by means of spiral CT angiography, which included 3D reconstruction. These findings were compared with those at DSA Results: In 16 patients, 20 aneurysms were found; the remaining patient had an ectatic vessel that simulated an aneurysm. Seventeen of the angiographically proved aneurysms were detected at CT angiography (sensitivity 85%). One further aneurysm was identified retrospectively as the result of greater experience in the method. All the aneurysms that escaped detection at CT were 3 mm in size. All the vessels of the circle of Willis, except for the posterior communicating artery, were properly evaluated at CT angiography. Difficulties were encountered in assessing the posterior communicating artery and the extradural segment of the internal carotid artery owing to their close spatial relationship to the bony structures of the skull base and the cavernous sinus Conclusion: CT angiography is a low-risk technique with a low level of invasiveness that is useful in following up known aneurysms. The 3D reconstruction yields further topographic information that helps in the planning of endovascular or surgical intervention. The facility for rotating the reconstructed vessels and displaying them from different angles is of particular value in cases difficult to assess at angiography

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