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血管造影 CT 静脉注射造影剂与传统旋转血管造影在脑动脉瘤诊断中的比较。

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

机构信息

Department of Neuroradiology, University of Erlangen-Nuremberg, Schwabachanlage 6, 91052 Erlangen, Germany.

出版信息

AJNR Am J Neuroradiol. 2012 May;33(5):982-7. doi: 10.3174/ajnr.A2883. Epub 2012 Jan 19.

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.

摘要

背景与目的

颅内动脉瘤的无创性成像仍被认为不如传统血管造影。本研究的目的是评估 ivACT 在评估颅内动脉瘤方面与 3D-DSA 的诊断准确性。

材料与方法

我们纳入了 13 例 15 个偶然发现的未破裂的囊状动脉瘤患者,这些患者计划进行诊断性血管造影检查。在每位患者中,我们进行了 ivACT 和常规血管造影检查,包括 3D 旋转运行。在后期处理中,为每种技术生成 MPR 图像。测量每个动脉瘤的最大动脉瘤直径、颈部直径、动脉瘤高度、最大宽度、隆起高度、母动脉直径和母动脉与动脉瘤顶点之间的角度。

结果

3D-DSA 和 ivACT 均提供了高质量的图像,没有人为干扰(即运动伪影)。两种模态的所有参数测量结果均具有可比性,且相关性较强(P ≤.001)。

结论

ivACT 可用于囊状脑动脉瘤的无创可视化,并且可以为评估动脉瘤大小和几何形状提供可靠的诊断信息,与传统的动脉内 3D 旋转血管造影相当。这些初步结果可能是替代传统血管造影术进行术前动脉瘤成像的第一步。

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