Struffert Tobias, Richter Gregor, Engelhorn Tobias, Doelken Marc, Goelitz Philipp, Kalender Willi A, Ganslandt Oliver, Doerfler Arnd
Department of Neuroradiology, University of Erlangen-Nuernberg, Erlangen, Germany.
Eur Radiol. 2009 Mar;19(3):619-25. doi: 10.1007/s00330-008-1183-7. Epub 2008 Sep 24.
The aim of the study was to test the reliability of intracerebral haemorrhage (ICH) detection with C-arm-mounted flat-detector computed tomography (FD-CT) in the angio suite as compared to multislice CT (MSCT). In this study 44 patients with 45 ICH were included. All patients were investigated with MSCT and FD-CT during angiographic evaluation. As a control group we included 16 patients without ICH. In each haematoma we assessed volumetric data of the ICH and counted the numbers of ICH-positive slices. Using interobserver ratings, we additionally investigated the potential of FD-CT to serve as a diagnostic tool to detect ICH. In FD-CT three haematomas were not detected because of motion and beam-hardening artefacts in the region close to the skull base. The r value for the degree of interobserver agreement for the number of slices was 0.95 for MSCT and 0.94 for FD-CT. Measurements of the area and the calculated volume of the ICH showed high inter- and intraobserver agreement. Our results indicate that FD-CT is a helpful tool in the daily emergency management of ICH patients as detection of ICH was found to be nearly as reliable as in MSCT. Limitations of this technology are motion and beam-hardening artefacts that may mask small haematomas located in the posterior fossa or the skull base.
本研究的目的是测试与多层螺旋CT(MSCT)相比,血管造影套件中配备C形臂平板探测器计算机断层扫描(FD-CT)检测脑出血(ICH)的可靠性。本研究纳入了44例患者共45处脑出血。所有患者在血管造影评估期间均接受了MSCT和FD-CT检查。作为对照组,我们纳入了16例无脑出血的患者。在每个血肿中,我们评估了脑出血的体积数据并计算了脑出血阳性切片的数量。通过观察者间评分,我们还研究了FD-CT作为检测脑出血诊断工具的潜力。在FD-CT检查中,由于靠近颅底区域的运动和线束硬化伪影,有3处血肿未被检测到。MSCT切片数量观察者间一致性程度的r值为0.95,FD-CT为0.94。脑出血面积测量和计算体积显示观察者间和观察者内一致性较高。我们的结果表明,FD-CT在脑出血患者的日常急诊管理中是一种有用工具,因为发现脑出血检测的可靠性与MSCT几乎相同。该技术的局限性是运动和线束硬化伪影,可能会掩盖位于后颅窝或颅底的小血肿。