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Comparative Study
. 2012 May;33(5):982-7.
doi: 10.3174/ajnr.A2883. Epub 2012 Jan 19.

Angiographic CT with intravenous contrast injection compared with conventional rotational angiography in the diagnostic work-up of cerebral aneurysms

P Gölitz  1 , T Struffert, F Knossalla, M Saake, S Ott, O Ganslandt, A Doerfler
Affiliations
Comparative Study

Angiographic CT with intravenous contrast injection compared with conventional rotational angiography in the diagnostic work-up of cerebral aneurysms

P Gölitz et al. AJNR Am J Neuroradiol. 2012 May.

Abstract

Background and purpose: Noninvasive imaging of cerebral aneurysms is still considered inferior to conventional angiography. The purpose of this study was to evaluate the diagnostic accuracy of ivACT in the assessment of intracranial aneurysms compared with 3D-DSA.

Materials and methods: We included 13 patients with 15 incidental unruptured saccular aneurysms scheduled for diagnostic angiographic work-up in our study. In each patient, we performed an ivACT and a conventional angiography including a 3D rotational run. During postprocessing, MPR images were generated for each technique. Maximal aneurysm diameter, neck diameter, aneurysm height, maximum width, bulge height, parent artery diameter, and angle between the parent artery and aneurysm apex were measured for each aneurysm.

Results: 3D-DSA and ivACT both provided images of high quality without artificial disturbances (ie, motion artifacts). Measurements of all parameters resulted in comparable values for both modalities with a strong correlation (P ≤ .001).

Conclusions: ivACT is feasible for the noninvasive visualization of saccular cerebral aneurysms and may provide reliable diagnostic information for the assessment of aneurysm size and geometry comparable with conventional intra-arterial 3D rotational angiography. These preliminary results might be a first promising step to replacing conventional angiography in preinterventional aneurysm imaging.

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Figures

Fig 1.
Fig 1.
Bilateral giant siphon aneurysms illustrated by maximum-intensity-projection (MIP) reconstructions of ivACT (A and D) and 3D-DSA (B and E) with the correlating 2D-DSA images (C and F). G, MIP reconstruction of ivACT of both aneurysms. ivACT allows the depiction of both aneurysms in only 1 examination step. In a comparison of both modalities, 3D-DSA provides a more distinct image impression, but the required information (ie, for device usage) can also be obtained by MIP reconstructions of ivACT.
Fig 2.
Fig 2.
An aneurysm of the ACA is presented by maximum-intensity-projection reconstructions of ivACT (A) and 3D-DSA (B). With ivACT, also the right-sided A1 and A2 segments of the ACA are highlighted in contrast to 3D-DSA.
Fig 3.
Fig 3.
Correlating maximum-intensity-projection reconstructions of ivACT (A) and 3D-DSA (B) both show a broad-based aneurysm of the right-sided pericallosal artery. 3D-DSA offers some more clarity for treatment, but the image information gained by ivACT seems sufficient for treatment planning.
Fig 4.
Fig 4.
A small basilar tip aneurysm is demonstrated by maximum-intensity-projection reconstructions of ivACT (A) and 3D-DSA (B). Both techniques seem to provide nearly identical images of the aneurysm.
Fig 5.
Fig 5.
Volume rendering technique reconstruction of ivACT shows opacification of all intracranial vessels in the anteroposterior view by only 1 contrast agent injection. An aneurysm in the bifurcation of the right middle cerebral artery is revealed.
See this image and copyright information in PMC

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