Department of Radiology, National Cardiovascular Center, Osaka, Japan.
Eur Radiol. 2009 Apr;19(4):1019-24. doi: 10.1007/s00330-008-1213-5. Epub 2008 Nov 11.
Dual-energy CT can be applied for bone elimination in cerebral CT angiography (CTA). The aim of this study was to compare the results of dual-energy direct bone removal CTA (DE-BR-CTA) with those of digital subtraction angiography (DSA). Twelve patients with intracranial aneurysms and/or ICA stenosis underwent a dual-source CT in dual-energy mode. Post-processing software selectively removed bone structures using the two energy data sets. Three-dimensional images with and without bone removal were reviewed and compared to DSA. Dual-energy bone removal was successful in all patients. For 10 patients, bone removal was good and CTA maximum-intensity projection (MIP) images could be used for vessel evaluation. For two patients, bone removal was moderate with some bone remnants, but this did not inhibit the three-dimensional visualization. Three aneurysms adjacent to the skull base were only partially visible in conventional CTA but were fully visible in DE-BR-CTA. In five patients with ICA stenosis, DE-BR-CTA revealed the stenotic lesions on the MIP images. The correlation between DSA and DE-BR-CTA was good (R (2)=0.822), but DE-BR-CTA led to an overestimation of stenosis. DE-BR-CTA was able to eliminate bone structure using only a single CT data acquisition and is useful to evaluate intracranial aneurysms and stenosis.
双能量 CT 可应用于脑 CT 血管造影（CTA）中的骨消除。本研究旨在比较双能直接骨消除 CTA（DE-BR-CTA）与数字减影血管造影（DSA）的结果。12 例颅内动脉瘤和/或颈内动脉狭窄患者进行了双源 CT 双能量模式检查。后处理软件使用两个能谱数据集选择性地去除骨结构。对有和无骨消除的三维图像进行回顾和与 DSA 比较。所有患者均成功进行了双能量骨消除。对于 10 例患者，骨消除良好，CTA 最大强度投影（MIP）图像可用于血管评估。对于 2 例患者，骨消除中度，有一些骨残余，但不影响三维可视化。3 个位于颅底附近的动脉瘤在常规 CTA 中仅部分可见，但在 DE-BR-CTA 中完全可见。在 5 例颈内动脉狭窄患者中，DE-BR-CTA 在 MIP 图像上显示狭窄病变。DSA 和 DE-BR-CTA 之间的相关性良好（R²=0.822），但 DE-BR-CTA 导致狭窄程度高估。DE-BR-CTA 仅通过单次 CT 数据采集即可消除骨结构，有助于评估颅内动脉瘤和狭窄。
