scholarly journals Discrepancy between two-dimensional and three-dimensional digital subtraction angiography for the planning of endovascular coiling of small cerebral aneurysms <5 mm

2020 ◽  
Vol 26 (6) ◽  
pp. 733-740
Author(s):  
Te-Chang Wu ◽  
Yu-Kun Tsui ◽  
Tai-Yuan Chen ◽  
Ching-Chung Ko ◽  
Chien-Jen Lin ◽  
...  
Keyword(s):  
Digital Subtraction Angiography ◽  
Three Dimensional ◽  
Cerebral Aneurysms ◽  
Endovascular Coiling ◽  
Parent Artery ◽  
Two Dimensional ◽  
Digital Subtraction ◽  
Rotational Angiography ◽  
Treatment Choices ◽  
The Impact

Background To investigate the discrepancy between two-dimensional digital subtraction angiography and three-dimensional rotational angiography for small (<5 mm) cerebral aneurysms and the impact on decision making among neuro-interventional experts as evaluated by online questionnaire. Materials and methods Eight small (<5 mm) ruptured aneurysms were visually identified in 16 image sets in either two-dimensional or three-dimensional format for placement in a questionnaire for 11 invited neuro-interventionalists. For each set, two questions were posed: Question 1: “Which of the following is the preferred treatment choice: simple coiling, balloon remodeling or stent assisted coiling?”; Question 2: “Is it achievable to secure the aneurysm with pure simple coiling?” The discrepancies of angio-architecture parameters and treatment choices between two-dimensional-digital subtraction angiography and three-dimensional rotational angiography were evaluated. Results In all eight cases, the neck images via three-dimensional rotational angiography were larger than two-dimensional-digital subtraction angiography with a mean difference of 0.95 mm. All eight cases analyzed with three-dimensional rotational angiography, but only one case with two-dimensional-digital subtraction angiography were classified as wide-neck aneurysms with dome-to-neck ratio < 1.5. The treatment choices based on the two-dimensional or three-dimensional information were different in 56 of 88 (63.6%) paired answers. Simple coiling was the preferred choice in 66 (75%) and 26 (29.6%) answers based on two-dimensional and three-dimensional information, respectively. Three types of angio-architecture with a narrow gap between the aneurysm sidewall and parent artery were proposed as an explanation for neck overestimation with three-dimensional rotational angiography. Conclusions Aneurysm neck overestimation with three-dimensional rotational angiography predisposed neuro-interventionalists to more complex treatment techniques. Additional two-dimensional information is crucial for endovascular treatment planning for small cerebral aneurysms.

Comparison of three-dimensional rotational angiography and digital subtraction angiography for the evaluation of the liver transplants

2009 ◽  
Vol 33 (2) ◽  
pp. 102-109 ◽  
Author(s):  
Ahmed M. Housseini ◽  
Ugur Bozlar ◽  
Timothy M. Schmitt ◽  
Hugo Bonatti ◽  
Bulent Arslan ◽  
...  
Keyword(s):  
Digital Subtraction Angiography ◽  
Three Dimensional ◽  
Digital Subtraction ◽  
Rotational Angiography ◽  
Liver Transplants

Pre-Embolization Study of Ruptured Cerebral Aneurysms with Helical CT

1999 ◽  
Vol 5 (1_suppl) ◽  
pp. 219-223 ◽  
Author(s):  
M. Nomura ◽  
S. Kida ◽  
N. Uchiyama ◽  
T. Yamashima ◽  
J. Yamashita ◽  
...  
Keyword(s):  
Digital Subtraction Angiography ◽  
Ct Angiography ◽  
Three Dimensional ◽  
Cerebral Aneurysms ◽  
Helical Ct ◽  
Digital Subtraction ◽  
Ruptured Aneurysms ◽  
Aneurysmal Neck ◽  
Anatomical Information ◽  
Rotational Digital Subtraction Angiography

Sixteen ruptured aneurysms in 16 patients considered endovascular embolizations were examined. The findings of axial source images (axial images) and reconstructed three-dimensional CT angiography (3D-CTA) of helical CT were compared to those of rotational digital subtraction angiography (DSA). The aneurysmal neck and arterial branches adjacent to the neck were closely investigated. In seven out of 16 cases (43.8%), information provided by axial images and/or 3D-CTA was more useful than that of rotational DSA in evaluating the aneurysmal neck and arterial branches. Helical CT can provide valuable information on ruptured aneurysms that cannot be obtained by rotational DSA in some patients. This technique is useful to obtain anatomical information about aneurysms and to select the best therapeutic method.

scholarly journals Comparing the Accuracy of Digital Subtraction Angiography, CT Angiography and MR Angiography at Estimating the Volume of Cerebral Aneurysms

2008 ◽  
Vol 14 (2) ◽  
pp. 173-177 ◽  
Author(s):  
M. Hanley ◽  
W.J. Zenzen ◽  
M.D. Brown ◽  
J.R. Gaughen ◽  
A.J. Evans
Keyword(s):  
Digital Subtraction Angiography ◽  
Ct Angiography ◽  
Mr Angiography ◽  
Clinical Decision Making ◽  
Cerebral Aneurysms ◽  
Error Rates ◽  
Imaging Modalities ◽  
Parent Artery ◽  
Digital Subtraction ◽  
True Variance

While there are many studies that compare imaging modalities in the detection of cerebral aneurysms there are no existing studies that compare two dimensional digital subtraction angiography (DSA), CT angiography (CTA) and MR angiography (MRA) in calculating the volume of cerebral aneurysms. This study will compare these imaging modalities on seven in-vitro models of known volume. Seven silicone models of cerebral aneurysms were chosen representing slight variations in geometric shape and size. The volume of each model was measured by weighing the amount of water required to fill the aneurysm to the parent artery. Contrast enhanced images of the models were taken with DSA, CTA and MRA. The images were interpreted by four independent readers and the volumes were calculated. The measured volumes from the water weight analysis were compared to the volumes calculated from the interpreter's measurements. The accuracy of DSA, CTA and MRA were compared using the percent of absolute and true variance from the measured volume. The average percent absolute variance for DSA was 14.3%, CTA was 16.8% and MRA was 18.6%. While these differences were minimal, comparing the percent of true variance demonstrated an average variance of −1.9% for DSA, 16.1% for CTA and −15.9% for MRA. Calculating the volume of cerebral aneurysms, while increasingly important, is difficult and error prone. It is important to understand the limitations and inherent errors before relying on calculated volumes in clinical decision-making. Regardless of imaging modality, one should consider error rates of 14–19% for calculating volume while keeping in mind the tendency for CTA to overestimate volume, MRA to underestimate volume and DSA to both under and overestimate equally.

scholarly journals Radiation Dose from 3D Rotational vs. Conventional 2D Digital Subtraction Angiography in Intracranial Aneurysm Coiling

2015 ◽  
Vol 42 (3) ◽  
pp. 176-180 ◽  
Author(s):  
Elena Tonkopi ◽  
Ahmed H. Al-Habsi ◽  
Jai J. S. Shankar
Keyword(s):  
Intracranial Aneurysm ◽  
Effective Dose ◽  
Digital Subtraction Angiography ◽  
Image Intensifier ◽  
Endovascular Coiling ◽  
Skin Dose ◽  
Digital Subtraction ◽  
Dose Area Product ◽  
Ion Chamber ◽  
The Impact

AbstractPurpose: To compare patient effective dose resulting from two alternative imaging protocols for pre-coiling assessment of intracranial aneurysms: a series of 2D Digital Subtraction Angiography (DSA) projections, and a 3D rotational angiography (RA) acquisition. Methods: In a retrospective analysis, we investigated 44 patients who underwent endovascular coiling in our institution. Images were acquired on a biplane Image Intensifier system not equipped with dose-area product (DAP) meter. Conventional 2D DSA images were simulated with an anthropomorphic skull phantom. Entrance skin dose was measured with a 60 cc ion chamber, and the PCXMC Monte Carlo based software was used to calculate patient effective dose. For the RA protocol, a 16 cm computed tomography (CT) dosimetry phantom and a 100 mm pencil ion chamber were employed to measure the CT dose index. Patient effective dose was calculated with the ImPACT calculator. An unpaired two-tailed t-test was used to determine the significance of differences between patient doses in each group. Results: Sixteen patients underwent the 2D DSA protocol with multiple projections; their mean number of cine runs was 5.1; the mean effective dose was 2.11 millisievert (mSv) (range 1.69–3.43 mSv). Twenty eight patients were assessed using the 3D RA protocol with the effective dose of 1.29 mSv. The difference between the means of two dose distributions was statistically significant (p=0.00028). Conclusion: Our study demonstrated that the patient effective dose was significantly lower from the 3D RA protocol than that from the 2D DSA protocol used in the planning of coiling of intracranial aneurysm.

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