scholarly journals Assessing the quality of angiographic display of brain blood vessels aneurysms compared to intraoperative state

2013 ◽  
Vol 70 (12) ◽  
pp. 1117-1123 ◽  
Author(s):  
Igor Nikolic ◽  
Goran Tasic ◽  
Vladimir Jovanovic ◽  
Nikola Repac ◽  
Aleksandar Janicijevic ◽  
...  
Keyword(s):  
Blood Vessels ◽  
Computed Tomographic Angiography ◽  
Conventional Angiography ◽  
Computed Tomographic ◽  
Advantages And Disadvantages ◽  
Spatial Reconstruction ◽  
Clinical Center ◽  
Preoperative Diagnostic ◽  
Clear Visibility ◽  
Tomographic Angiography

Background/Aim. Aneurysms in brain blood vessels are expanding bags composed of a neck, body and fundus. Clear visibility of the neck, the position of the aneurysm and surrounding structures are necessary for a proper choice of methods for excluding the aneurysm from the circulation. The aim of this study was to evaluate the reliability of spatial reconstruction of blood vessels of the brain based on the original software for 3D reconstruction of the equipment manufacturer and a personal computer model developed earlier in the Clinic for Neurosurgery, Clinical Center of Serbia, Belgrade, compared to intraoperative identification of these aneurysms. Methods. This study included 137 patients of both sexes. The presence of an aneurysm was verified by angiographic methods [computed tomographic angiography (CTA), multislice computed tomography angiography (MSCTA), magnetic resonance imaging angiography (MRA), or digital subtraction angiography (DSA)]. Results. The quality score (0 to 5) for CTA was 3.180 ? 0.961, MSCTA 4.062 ? 0.928, and for DSA 4.588 ? 0.758 (p < 0.01). The results of this study favorite conventional angiography as the gold standard for diagnostic of intracranial aneurysms. Conclusion. The results of this study are consistent with current publications review and clearly recognize the advantages and disadvantages of diagnostic neuroradiological procedures, with DSA of brain blood vessels as a binding preoperative diagnostic procedure in cases in who it is not possible to clearly visualize the supporting blood vessel and neck of the aneurysm by using the findings of CTA, MRA and MSCTA.

Space reconstruction of the aneurysms of the vertebrobasilary confluence based on conventional angiography: Our experience

2008 ◽  
Vol 55 (2) ◽  
pp. 75-78
Author(s):  
I.M. Nikolic ◽  
M.Lj. Rakic ◽  
E.E. Slavik ◽  
G.M. Tasic ◽  
B.M. Djurovic ◽  
...  
Keyword(s):  
Blood Vessels ◽  
Diagnostic Procedures ◽  
Conventional Angiography ◽  
Two Dimensional Image ◽  
Diagnostic Protocol ◽  
Clinical Center ◽  
Golden Standard ◽  
Preoperative Diagnostic ◽  
Third Dimension ◽  
Initial Results

Besides current development of the new diagnostic procedures conventional angiography still represents the golden standard in the diagnosing of intracranial aneurysms. Since it gives a two-dimensional image if the presentation of the third dimension is wanted it is necessary to apply appropriate algorithm structures and computers. In this study we show our experience in the application of space reconstruction of blood vessels and aneurysms of the vertebrobasilary confluence in 6 patients operated at the Institute for Neurosurgery, Clinical Center of Serbia. Intraoperative finding in all patients matched the finding that we got by space reconstruction of the blood vessels, which was possible to observe from different angles. Postoperative course in all patients was satisfying. Upon discharge the patients were without rough lateralization of the pyramidal system. Our initial results and their practical agreement with the interoperative finding give us right to recommend this method as the standard for the preoperative diagnostic protocol.

Utility of Three-dimensional Computed Tomographic Angiography for Assessment of Relationships between the Vertebrobasilar System and the Cranial Base

Neurosurgery ◽  
2001 ◽  
Vol 48 (2) ◽  
pp. 318-327 ◽  
Author(s):  
Alan T. Villavicencio ◽  
Linda Gray ◽  
Jean-Christophe Leveque ◽  
Takanori Fukushima ◽  
Sohaib Kureshi ◽  
...  
Keyword(s):  
Basilar Artery ◽  
Three Dimensional ◽  
Cranial Base ◽  
Computed Tomographic Angiography ◽  
Conventional Angiography ◽  
Computed Tomographic ◽  
Vertebrobasilar System ◽  
Tomographic Angiography ◽  
Relationship Of ◽  
The Relationship

Abstract OBJECTIVE The optimal surgical exposure for basilar tip aneurysms is dictated by the relationship of the basilar bifurcation to the cranial base. This study was designed to evaluate three-dimensional computed tomographic angiography as a means of obtaining detailed anatomic information on the basilar artery and the surrounding cranial base in individual patients before surgery. METHODS We studied 30 patients using three-dimensional computed tomographic angiographic reconstructions from 1-mm computed tomographic slices. Detailed anatomic measurements were performed to define the relationship between the basilar artery and the cranial base. Particular attention was paid to the height of the dorsum sellae and its relationship to the basilar bifurcation. RESULTS The heights of the basilar apex and the vertebrobasilar junction, relative to the cranial base, were extremely variable. Considerable asymmetries in the heights of the left and right posterior clinoid processes were identified; in one case, this difference was more than 1 cm (mean difference in height, 0.9 mm; range, 0–10.3 mm). The heights of the posterior clinoid processes above the sellar floor ranged from 5.8 to 14.1 mm (mean height, 9.5 mm). We were able to determine the feasibility of the pterional/orbitozygomatic, middle fossa/anterior petrosal, and presigmoid retrolabyrinthine approaches to an individual basilar bifurcation. We also estimated the amount of bone removal required and determined the operative distances via those approaches. CONCLUSION Three-dimensional computed tomographic angiography is a useful tool for assessing critical anatomic relationships and represents an adjunct to conventional angiography in the planning of individualized, precisely tailored, cranial base approaches to the vertebrobasilar system.

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