scholarly journals Application of computed tomography angiography for evaluating clinical morphology in intracranial aneurysms – monocentric study

2019 ◽  
Vol 48 (4) ◽  
pp. 030006051989479
Author(s):  
Ru-de Sui ◽  
Chun-guo Wang ◽  
Dong-wei Han ◽  
Xiu-qing Zhang ◽  
Qing Li ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Computed Tomography Angiography ◽  
Intracranial Aneurysms ◽  
Parent Artery ◽  
Neck Width ◽  
Aneurysm Size ◽  
Aneurysmal Neck ◽  
The Relationship ◽  
Accuracy Rates ◽  
Guiding Effect

Objective To examine the clinical effect of computed tomography angiography (CTA) on parameters of intracranial aneurysms in different locations and with different sizes using digital subtraction angiography (DSA) as the standard. Methods Patients with intracranial aneurysms who underwent CTA examinations at the same center and received DSA examinations within 3 days were analyzed retrospectively. The morphological parameters of the aneurysms and parent arteries were measured with these two methods. Results Mean aneurysm size and parent artery diameter were not different between CTA and DSA. The size of microaneurysms was significantly smaller with DSA than with CTA. The aneurysmal neck width was not different between CTA and DSA. DSA could clearly evaluate the relationship between the aneurysmal neck and the parent artery in all cases. However, CTA had a 90% accuracy rate of visualizing this relationship. Conclusion The accuracy rates of evaluating aneurysm size and the aneurysmal neck width and parent artery diameter are similar between CTA and DSA. A DSA examination is essential for evaluating the relationship among microaneurysms, the aneurysmal neck, and the parent artery. CTA is widely applied and more safe in clinical practice, while DSA has a better guiding effect than CTA for some complicated aneurysms.

scholarly journals Endosaccular Flow Disruption: A New Frontier in Endovascular Aneurysm Management

Neurosurgery ◽  
2019 ◽  
Vol 86 (2) ◽  
pp. 170-181 ◽  
Author(s):  
Adam A Dmytriw ◽  
Mohamed M Salem ◽  
Victor X D Yang ◽  
Timo Krings ◽  
Vitor M Pereira ◽  
...  
Keyword(s):  
Paradigm Shift ◽  
Intracranial Aneurysms ◽  
Parent Artery ◽  
Endovascular Techniques ◽  
Flow Modification ◽  
Flow Disruption ◽  
Fda Approval ◽  
New Frontier ◽  
Trial Basis ◽  
Aneurysmal Neck

Abstract Flow modification has caused a paradigm shift in the management of intracranial aneurysms. Since the FDA approval of the Pipeline Embolization Device (Medtronic, Dublin, Ireland) in 2011, it has grown to become the modality of choice for a range of carefully selected lesions, previously not amenable to conventional endovascular techniques. While the vast majority of flow-diverting stents operate from within the parent artery (ie, endoluminal stents), providing a scaffold for endothelial cells growth at the aneurysmal neck while inducing intra-aneurysmal thrombosis, a smaller subset of endosaccular flow disruptors act from within the lesions themselves. To date, these devices have been used mostly in Europe, while only utilized on a trial basis in North America. To the best of our knowledge, there has been no dedicated review of these devices. We therefore sought to present a comprehensive review of currently available endosaccular flow disruptors along with high-resolution schematics, presented with up-to-date available literature discussing their technical indications, procedural safety, and reported outcomes.

Interrater Agreement in the Radiologic Characterization of Ruptured Intracranial Aneurysms Based on Computed Tomography Angiography

2017 ◽  
Vol 103 ◽  
pp. 876-882.e1 ◽  
Author(s):  
Nicolai Maldaner ◽  
Martin N. Stienen ◽  
Philippe Bijlenga ◽  
Davide Croci ◽  
Daniel W. Zumofen ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Computed Tomography Angiography ◽  
Intracranial Aneurysms ◽  
Interrater Agreement ◽  
Ruptured Intracranial Aneurysms

Morphological Effect on Wall Shear Stress in Intracranial Aneurysms

2017 ◽  
Vol 79 (02) ◽  
pp. 108-115 ◽  
Author(s):  
Tian-Lun Qiu ◽  
Guo-Liang Jin ◽  
Hai-Tao Lu ◽  
Wu-Qiao Bao
Keyword(s):  
Shear Stress ◽  
Wall Shear Stress ◽  
Intracranial Aneurysms ◽  
Multivariable Analysis ◽  
Morphological Characteristics ◽  
Parent Artery ◽  
Parent Vessel ◽  
Morphological Effect ◽  
Neck Width ◽  
Wall Shear

Background and Study Aims Both high and low wall shear stress (WSS) play important roles in the development and rupture of intracranial aneurysms (IAs). This study aimed to determine the morphological factors that affect WSS in the IA and the parent artery. Material and Methods We studied a total of 66 IAs with three-dimensional imaging. Computational fluid dynamics (CFD) models were constructed and used to characterize the hemodynamics quantitatively. Aneurysms were grouped according to the mean neck width. The associations among hemodynamics and morphology were analyzed. Results Aspect ratio was correlated to lowest WSS (r = − 0.576), aneurysm-to-parent vessel (A-P) WSS ratio (r = − 0.500), and lowest-parent vessel (L-P) WSS ratio (r = − 0.575). Height-to-width ratio and height were correlated to WSS. Mean aneurysm WSS (p = 0.023), lowest WSS (p < 0.0001), highest-to-lowest WSS ratio (p = 0.004), L-P WSS ratio (p < 0.0001), highest-parent vessel (H-P) WSS ratio (p = 0.008), A-P WSS ratio (p < 0.001), and height (p < 0.001) were different between the two groups of aneurysms that were divided by the relationship between the diameters of the aneurysms and the necks. Multivariable analysis showed that the lowest WSS (p = 0.028) and A-P WSS ratio (p = 0.001) were independently associated with neck width. Conclusion Morphological characteristics are associated with IA and parent vessel WSS. Aneurysms with different neck widths have different hemodynamics. These results could help in understanding the progression of IA and in building predictive models for IA rupture.

Computed Tomography Angiography Evaluation of Risk Factors for Unstable Intracranial Aneurysms

2018 ◽  
Vol 115 ◽  
pp. e27-e32 ◽  
Author(s):  
Guang-xian Wang ◽  
Ming-fu Gong ◽  
Li Wen ◽  
Lan-lan Liu ◽  
Jin-bo Yin ◽  
...  
Keyword(s):  
Risk Factors ◽  
Computed Tomography ◽  
Computed Tomography Angiography ◽  
Intracranial Aneurysms

scholarly journals Consistency in Geometry Among Coronary Atherosclerotic Plaques Extracted From Computed Tomography Angiography

2021 ◽  
Vol 12 ◽  
Author(s):  
Haipeng Liu ◽  
Aleksandra Wingert ◽  
Xinhong Wang ◽  
Jucheng Zhang ◽  
Jianzhong Sun ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Power Function ◽  
Computed Tomography Angiography ◽  
Geometric Parameters ◽  
Atherosclerotic Plaques ◽  
Geometric Properties ◽  
Artery Disease ◽  
The Relationship

Background: The three-dimensional (3D) geometry of coronary atherosclerotic plaques is associated with plaque growth and the occurrence of coronary artery disease. However, there is a lack of studies on the 3D geometric properties of coronary plaques. We aim to investigate if coronary plaques of different sizes are consistent in geometric properties.Methods: Nineteen cases with symptomatic stenosis caused by atherosclerotic plaques in the left coronary artery were included. Based on attenuation values on computed tomography angiography images, coronary atherosclerotic plaques and calcifications were identified, 3D reconstructed, and manually revised. Multidimensional geometric parameters were measured on the 3D models of plaques and calcifications. Linear and non-linear (i.e., power function) fittings were used to investigate the relationship between multidimensional geometric parameters (length, surface area, volume, etc.). Pearson correlation coefficient (r), R-squared, and p-values were used to evaluate the significance of the relationship. The analysis was performed based on cases and plaques, respectively. Significant linear relationship was defined as R-squared &gt; 0.25 and p &lt; 0.05.Results: In total, 49 atherosclerotic plaques and 56 calcifications were extracted. In the case-based analysis, significant linear relationships were found between number of plaques and number of calcifications (r = 0.650, p = 0.003) as well as total volume of plaques (r = 0.538, p = 0.018), between number of calcifications and total volume of plaques (r = 0.703, p = 0.001) as well as total volume of calcification (r = 0.646, p = 0.003), and between the total volumes of plaques and calcifications (r = 0.872, p &lt; 0.001). In plaque-based analysis, the power function showed higher R-squared values than the linear function in fitting the relationships of multidimensional geometric parameters. Two presumptions of plaque geometry in different growth stages were proposed with simplified geometric models developed. In the proposed models, the exponents in the power functions of geometric parameters were in accordance with the fitted values.Conclusion: In patients with coronary artery disease, coronary plaques and calcifications are positively related in number and volume. Different coronary plaques are consistent in the relationship between geometry parameters in different dimensions.

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