Three-dimensional bone-free computed tomographic angiography of aneurysms near the skull base using a new bone-removal application

Abstract

Purpose: Bone elimination is needed for computed tomography angiography (CTA) because bone structures obscure aneurysms located at the skull base. The purpose of our study was to evaluate the efficacy of three-dimensional (3D)-CTA using an application for bone elimination.

Materials and methods: A total of 27 patients with 32 angiographically confirmed aneurysms near the skull base were investigated. The 3D maximum intensity projection (MIP) images were initially obtained using the application. Further postprocessing was performed to obtain the MIP and volume-rendered (VR) images. The quality of the initial MIP images by the application was analyzed. Visualization of aneurysms after further processing was also reviewed.

Results: The initial MIP images by the application showed almost bone-free images in 23 of the 27 patients. In 8 patients, the image of the internal carotid artery (ICA) was segmentally removed in the initial MIP images by the application. Further postprocessing was able to recover all loss of the ICA image in these eight patients. For visualizing aneurysms and their necks, VR images with the application were significantly superior to VR images without the application.

Conclusion: The application for bone elimination allows fast, selective elimination of bony structures and can improve the interpretation of aneurysms near the skull base.