Department of Clinical Radiology, University of Muenster, Muenster, Germany.
Clin Radiol. 2010 Jun;65(6):440-6. doi: 10.1016/j.crad.2010.03.002. Epub 2010 Apr 18.
To evaluate the impact of bone subtraction computed tomography angiography (BS-CTA) for the assessment of transcranial arteries in comparison with standard CTA (S-CTA) without bone removal and time-of-flight magnetic resonance angiography (TOF-MRA).
Cranial unenhanced CT and S-CTA were performed in 53 patients with suspected cerebrovascular disease. BS-CTA datasets were reconstructed from the S-CTA and unenhanced CT source images. TOF-MRA was performed within 24h after CTA on a 1.5 T MRI system. Two radiologists, in consensus, evaluated the segments of the internal carotid artery (C2-C7), the vertebral artery (V4), and the basilar artery for the degree of stenosis. A five-step scale (0-49, 50-69, 70-89, 90-99% and occlusion) for the degree of stenosis was applied for all segments. Wilcoxon's signed rank test was used for statistical analysis.
Seven hundred and fifty vessel segments (ICA:636, VA:106, BA:53) were analysed. The degree of stenosis on S-CTA was consistent with TOF-MRA in all segments. BS-CTA showed a trend towards higher stenosis scores in cases of calcified plaques compared to S-CTA (p=0.11) and TOF-MRA (p=0.09), which was not statistically significant. In transcranial segments, BS-CTA revealed equivalent scores compared to S-CTA and TOF-MRA (p=0.25; p=0.20).
BS-CTA produced similar results to TOF-MRA and S-CTA and can be applied as a non-invasive imaging method for the transcranial arteries. However, BS-CTA shows a trend towards overestimation of the degree of stenosis.
评估骨减影 CT 血管造影（BS-CTA）在评估颅外动脉方面与标准 CTA（S-CTA）和时间飞跃磁共振血管造影（TOF-MRA）的比较。
对 53 例疑诊脑血管病患者进行颅部非增强 CT 和 S-CTA 检查。BS-CTA 数据集从 S-CTA 和非增强 CT 源图像重建。TOF-MRA 在 CTA 后 24 小时内在 1.5T MRI 系统上进行。两位放射科医生一致评估颈内动脉（C2-C7）、椎动脉（V4）和基底动脉的狭窄程度。所有节段均采用狭窄程度五分制（0-49、50-69、70-89、90-99%和闭塞）。Wilcoxon 符号秩检验用于统计分析。
分析了 750 个血管节段（ICA：636，VA：106，BA：53）。S-CTA 上的狭窄程度与所有节段的 TOF-MRA 一致。与 S-CTA（p=0.11）和 TOF-MRA（p=0.09）相比，BS-CTA 显示钙化斑块的狭窄程度有升高的趋势，但无统计学意义。在颅外节段，BS-CTA 与 S-CTA 和 TOF-MRA 的评分相当（p=0.25；p=0.20）。
BS-CTA 与 TOF-MRA 和 S-CTA 结果相似，可作为颅外动脉的一种无创成像方法。然而，BS-CTA 显示出高估狭窄程度的趋势。
