Department of Neuroradiology, University Medicine Goettingen, Goettingen, Germany.
AJNR Am J Neuroradiol. 2010 Aug;31(7):1226-31. doi: 10.3174/ajnr.A2086. Epub 2010 Apr 1.
The ability to perform neuroimaging on the angiography suite is important in making decisions during neurointerventions. Our aim was the evaluation of ACT as a fast available diagnostic tool during and after neuroendovascular procedures and the comparison of ACT with postinterventional MDCT.
Eighty-four peri-interventional ACT acquisitions were obtained and evaluated: 38 after coil embolization of cerebral aneurysms, 16 after intracranial angioplasty with stent placement, and 30 after endovascular mechanical thrombectomy and lysis. Interventions and ACTs were performed on a biplane angiography system equipped with flat panel detectors. Postprocessing was performed on a dedicated workstation, and multiplanar reformations were generated. Reference studies were performed on a 16- or 128-section MDCT scanner. All studies were independently evaluated by 3 blinded neuroradiologists. The Wilcoxon test was applied for the statistical analysis.
ACT and MDCT images were of equal diagnostic quality in most cases related to the supratentorial ventricular system and the detection of hemorrhages (subarachnoidal, intraparenchymal, and intraventricular). Regarding the supratentorial ventricular system, an adequate diagnostic quality was assigned to 94% of the ACT acquisitions. For the detection of hemorrhage, no statistically significant difference was noted between ACT and MDCT. However, for the infratentorial region, ACT performed relatively poorly compared with MDCT. The diagnostic evaluation of gray matter (basal ganglia, insular cortex, and central cortex) by ACT is not sufficient, with <20% of the acquisitions scoring a diagnostic value.
After neuroendovascular procedures and within the angiography suite, ACT enables an immediate detection of peri-interventional hemorrhage or hydrocephalus. However, for the detection of cerebral infarction, ACT is not yet reliable.
在神经介入过程中，能够在血管造影套件上进行神经影像学检查对于决策至关重要。我们的目的是评估 ACT 作为一种在神经血管内介入过程中和之后快速可用的诊断工具，并将其与介入后 MDCT 进行比较。
获得并评估了 84 例介入期间的 ACT 采集：38 例大脑动脉瘤线圈栓塞后，16 例颅内血管成形术伴支架置入后，30 例血管内机械血栓切除术和溶栓后。在配备平板探测器的双平面血管造影系统上进行介入和 ACT。在专用工作站上进行后处理，并生成多平面重建。参考研究在 16 或 128 层 MDCT 扫描仪上进行。所有研究均由 3 名盲法神经放射科医生独立评估。应用 Wilcoxon 检验进行统计学分析。
在大多数与幕上脑室系统和出血（蛛网膜下腔、脑实质和脑室内）检测相关的情况下，ACT 和 MDCT 图像具有同等的诊断质量。在幕上脑室系统方面，94%的 ACT 采集获得了足够的诊断质量。在出血检测方面，ACT 和 MDCT 之间没有统计学上的显著差异。然而，对于后颅窝区域，ACT 的表现相对较差，与 MDCT 相比。ACT 对灰质（基底节、脑岛皮质和中央皮质）的诊断评估不足，<20%的采集评分具有诊断价值。
在神经血管内介入后和血管造影套件内，ACT 能够立即检测到介入期间的出血或脑积水。然而，对于脑梗死的检测，ACT 还不可靠。
