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Erschienen in: European Radiology 10/2011

01.10.2011 | Neuro

The value of dual-energy CTA for control of surgically clipped aneurysms

Erschienen in: European Radiology | Ausgabe 10/2011

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Abstract

Objective

Comparison of image quality in DE-CTA with and without automatic head bone removal (BR) versus CTA with 16-detectors as a tool in postoperative evaluation of patients after neurosurgical clipping.

Methods

In this study 30 aneurysms that had undergone neurosurgical clipping were included: 18 with DE-CTA and 12 with conventional CTA. The images were further processed using the volume rendering technique (VRT) and BR. Two experienced neuroradiologists reviewed the images regarding the severity of artefacts surrounding the clip, visibility of the vessels and remnant necks. The results were compared with DSA images, if performed.

Results

Significantly fewer disturbances by artefacts were observed in DE-CTA versus CTA in a 16-row system. Visibility of the surrounding vessels was satisfying in both techniques and there were comparable results with DSA with only one exception. All images produced with 140 kV provided fewer artefacts than those with 80 kV.

Conclusion

DE-CTA provides better image quality with fewer disturbances by clip artefact, a satisfying evaluation of remnant aneurysm necks and the surrounding vessels. As this method is easily performed and readily accessible with fast image post-processing using BR it provides an opportunity to avoid invasive DSA in the evaluation of suspected aneurysm rests.
Literatur
1.
Zurück zum Zitat Young N, Dorsch NW, Kingston RJ, Markson G, McMahon J (2001) Intracranial aneurysms: evaluation in 200 patients with spiral CT angiography. Eur Radiol 11:123–130PubMedCrossRef Young N, Dorsch NW, Kingston RJ, Markson G, McMahon J (2001) Intracranial aneurysms: evaluation in 200 patients with spiral CT angiography. Eur Radiol 11:123–130PubMedCrossRef
2.
Zurück zum Zitat Sagara Y, Kiyosue H, Hori Y et al (2005) Limitations of three-dimensional reconstructed computerized tomography angiography after clip placement for intracranial aneurysms. J Neurosurg 103:656–661PubMedCrossRef Sagara Y, Kiyosue H, Hori Y et al (2005) Limitations of three-dimensional reconstructed computerized tomography angiography after clip placement for intracranial aneurysms. J Neurosurg 103:656–661PubMedCrossRef
3.
Zurück zum Zitat van der Schaaf IC, Velthuis BK, Wermer MJ et al (2006) Multislice computed tomography angiography screening for new aneurysms in patients with previously clip-treated intracranial aneurysms: Feasibility, positive predictive value, and interobserver agreement. J Neurosurg 105:682–688PubMedCrossRef van der Schaaf IC, Velthuis BK, Wermer MJ et al (2006) Multislice computed tomography angiography screening for new aneurysms in patients with previously clip-treated intracranial aneurysms: Feasibility, positive predictive value, and interobserver agreement. J Neurosurg 105:682–688PubMedCrossRef
4.
Zurück zum Zitat U-King-Im JM, Koo B, Trivedi RA et al (2005) Current diagnostic approaches to subarachnoid haemorrhage. Eur Radiol 15:1135–1147PubMedCrossRef U-King-Im JM, Koo B, Trivedi RA et al (2005) Current diagnostic approaches to subarachnoid haemorrhage. Eur Radiol 15:1135–1147PubMedCrossRef
5.
Zurück zum Zitat White PM, Wardlaw JM, Easton V (2000) Can noninvasive imaging accurately depict intracranial aneurysms? A systematic review. Radiology 217:361–370PubMed White PM, Wardlaw JM, Easton V (2000) Can noninvasive imaging accurately depict intracranial aneurysms? A systematic review. Radiology 217:361–370PubMed
6.
Zurück zum Zitat Le Roux PD, Elliott JP, Eskridge JM, Cohen W, Winn HR (1998) Risks and benefits of diagnostic angiography after aneurysm surgery: a retrospective analysis of 597 studies. Neurosurgery 42:1248–1254, discussion 1254–1245PubMedCrossRef Le Roux PD, Elliott JP, Eskridge JM, Cohen W, Winn HR (1998) Risks and benefits of diagnostic angiography after aneurysm surgery: a retrospective analysis of 597 studies. Neurosurgery 42:1248–1254, discussion 1254–1245PubMedCrossRef
7.
Zurück zum Zitat Kaufmann TJ, Huston J 3rd, Mandrekar JN et al (2007) Complications of diagnostic cerebral angiography: evaluation of 19,826 consecutive patients. Radiology 243:812–819PubMedCrossRef Kaufmann TJ, Huston J 3rd, Mandrekar JN et al (2007) Complications of diagnostic cerebral angiography: evaluation of 19,826 consecutive patients. Radiology 243:812–819PubMedCrossRef
8.
Zurück zum Zitat Cloft HJ, Joseph GJ, Dion JE (1999) Risk of cerebral angiography in patients with subarachnoid hemorrhage, cerebral aneurysm, and arteriovenous malformation: a meta-analysis. Stroke 30:317–320PubMedCrossRef Cloft HJ, Joseph GJ, Dion JE (1999) Risk of cerebral angiography in patients with subarachnoid hemorrhage, cerebral aneurysm, and arteriovenous malformation: a meta-analysis. Stroke 30:317–320PubMedCrossRef
9.
Zurück zum Zitat Hankey GJ, Warlow CP, Sellar RJ (1990) Cerebral angiographic risk in mild cerebrovascular disease. Stroke 21:209–222PubMedCrossRef Hankey GJ, Warlow CP, Sellar RJ (1990) Cerebral angiographic risk in mild cerebrovascular disease. Stroke 21:209–222PubMedCrossRef
10.
Zurück zum Zitat Heiserman JE, Dean BL, Hodak JA et al (1994) Neurologic complications of cerebral angiography. AJNR Am J Neuroradiol 15:1401–1407, discussion 1408–1411PubMed Heiserman JE, Dean BL, Hodak JA et al (1994) Neurologic complications of cerebral angiography. AJNR Am J Neuroradiol 15:1401–1407, discussion 1408–1411PubMed
11.
Zurück zum Zitat Cademartiri F, Maffei E, Palumbo A et al (2009) Clinical applications of multi-detector computed tomography coronary angiography. Minerva Cardioangiol 57:349–357PubMed Cademartiri F, Maffei E, Palumbo A et al (2009) Clinical applications of multi-detector computed tomography coronary angiography. Minerva Cardioangiol 57:349–357PubMed
12.
Zurück zum Zitat Schwarz F, Ruzsics B, Schoepf UJ et al (2008) Dual-energy CT of the heart–principles and protocols. Eur J Radiol 68:423–433PubMedCrossRef Schwarz F, Ruzsics B, Schoepf UJ et al (2008) Dual-energy CT of the heart–principles and protocols. Eur J Radiol 68:423–433PubMedCrossRef
13.
Zurück zum Zitat Eliahou R, Hidas G, Duvdevani M, Sosna J (2010) Determination of renal stone composition with dual-energy computed tomography: an emerging application. Semin Ultrasound CT MR 31:315–320PubMedCrossRef Eliahou R, Hidas G, Duvdevani M, Sosna J (2010) Determination of renal stone composition with dual-energy computed tomography: an emerging application. Semin Ultrasound CT MR 31:315–320PubMedCrossRef
14.
Zurück zum Zitat Li Q, Lv F, Li Y et al (2009) Subtraction CT angiography for evaluation of intracranial aneurysms: comparison with conventional CT angiography. Eur Radiol 19:2261–2267PubMedCrossRef Li Q, Lv F, Li Y et al (2009) Subtraction CT angiography for evaluation of intracranial aneurysms: comparison with conventional CT angiography. Eur Radiol 19:2261–2267PubMedCrossRef
15.
Zurück zum Zitat Deng K, Liu C, Ma R et al (2009) Clinical evaluation of dual-energy bone removal in CT angiography of the head and neck: comparison with conventional bone-subtraction CT angiography. Clin Radiol 64:534–541PubMedCrossRef Deng K, Liu C, Ma R et al (2009) Clinical evaluation of dual-energy bone removal in CT angiography of the head and neck: comparison with conventional bone-subtraction CT angiography. Clin Radiol 64:534–541PubMedCrossRef
16.
Zurück zum Zitat Pechlivanis I, Koenen D, Engelhardt M et al (2008) Computed tomographic angiography in the evaluation of clip placement for intracranial aneurysm. Acta Neurochir Wien 150:669–676PubMedCrossRef Pechlivanis I, Koenen D, Engelhardt M et al (2008) Computed tomographic angiography in the evaluation of clip placement for intracranial aneurysm. Acta Neurochir Wien 150:669–676PubMedCrossRef
17.
Zurück zum Zitat Bakker NA, Westerlaan HE, Metzemaekers JD et al (2010) Feasibility of magnetic resonance angiography (MRA) follow-up as the primary imaging modality after coiling of intracranial aneurysms. Acta Radiol 51:226–232PubMedCrossRef Bakker NA, Westerlaan HE, Metzemaekers JD et al (2010) Feasibility of magnetic resonance angiography (MRA) follow-up as the primary imaging modality after coiling of intracranial aneurysms. Acta Radiol 51:226–232PubMedCrossRef
18.
Zurück zum Zitat Li Q, Lv F, Li Y et al (2009) Subtraction CT angiography for evaluation of intracranial aneurysms: comparison with conventional CT angiography. Eur Radiol 19:2261–2267PubMedCrossRef Li Q, Lv F, Li Y et al (2009) Subtraction CT angiography for evaluation of intracranial aneurysms: comparison with conventional CT angiography. Eur Radiol 19:2261–2267PubMedCrossRef
19.
Zurück zum Zitat Dehdashti AR, Binaghi S, Uske A, Regli L (2006) Comparison of multislice computerized tomography angiography and digital subtraction angiography in the postoperative evaluation of patients with clipped aneurysms. J Neurosurg 104:395–403PubMedCrossRef Dehdashti AR, Binaghi S, Uske A, Regli L (2006) Comparison of multislice computerized tomography angiography and digital subtraction angiography in the postoperative evaluation of patients with clipped aneurysms. J Neurosurg 104:395–403PubMedCrossRef
20.
Zurück zum Zitat Pechlivanis I, Konig M, Engelhardt M et al (2009) Evaluation of clip artefacts in three-dimensional computed tomography. Cen Eur Neurosurg 70:9–14PubMedCrossRef Pechlivanis I, Konig M, Engelhardt M et al (2009) Evaluation of clip artefacts in three-dimensional computed tomography. Cen Eur Neurosurg 70:9–14PubMedCrossRef
21.
Zurück zum Zitat Brown JH, Lustrin ES, Lev MH, Ogilvy CS, Taveras JM (1999) Reduction of aneurysm clip artifacts on CT angiograms: a technical note. AJNR Am J Neuroradiol 20:694–696PubMed Brown JH, Lustrin ES, Lev MH, Ogilvy CS, Taveras JM (1999) Reduction of aneurysm clip artifacts on CT angiograms: a technical note. AJNR Am J Neuroradiol 20:694–696PubMed
22.
Zurück zum Zitat Mamourian AC, Erkmen K, Pluta DJ (2008) Nonhelical acquisition CT angiogram after aneurysmal clipping: in vitro testing shows diminished artifact. AJNR Am J Neuroradiol 29:660–662PubMedCrossRef Mamourian AC, Erkmen K, Pluta DJ (2008) Nonhelical acquisition CT angiogram after aneurysmal clipping: in vitro testing shows diminished artifact. AJNR Am J Neuroradiol 29:660–662PubMedCrossRef
23.
Zurück zum Zitat Achenbach S, Ropers D, Kuettner A et al (2006) Contrast-enhanced coronary artery visualization by dual-source computed tomography–initial experience. Eur J Radiol 57:331–335PubMedCrossRef Achenbach S, Ropers D, Kuettner A et al (2006) Contrast-enhanced coronary artery visualization by dual-source computed tomography–initial experience. Eur J Radiol 57:331–335PubMedCrossRef
24.
Zurück zum Zitat Johnson TR, Krauss B, Sedlmair M et al (2007) Material differentiation by dual energy CT: initial experience. Eur Radiol 17:1510–1517PubMedCrossRef Johnson TR, Krauss B, Sedlmair M et al (2007) Material differentiation by dual energy CT: initial experience. Eur Radiol 17:1510–1517PubMedCrossRef
25.
Zurück zum Zitat van der Schaaf I, van Leeuwen M, Vlassenbroek A, Velthuis B (2006) Minimizing clip artifacts in multi CT angiography of clipped patients. AJNR Am J Neuroradiol 27:60–66PubMed van der Schaaf I, van Leeuwen M, Vlassenbroek A, Velthuis B (2006) Minimizing clip artifacts in multi CT angiography of clipped patients. AJNR Am J Neuroradiol 27:60–66PubMed
26.
Zurück zum Zitat Morhard D, Fink C, Graser A et al (2009) Cervical and cranial computed tomographic angiography with automated bone removal: dual energy computed tomography versus standard computed tomography. Invest Radiol 44:293–297PubMedCrossRef Morhard D, Fink C, Graser A et al (2009) Cervical and cranial computed tomographic angiography with automated bone removal: dual energy computed tomography versus standard computed tomography. Invest Radiol 44:293–297PubMedCrossRef
Metadaten
Titel
The value of dual-energy CTA for control of surgically clipped aneurysms
Publikationsdatum
01.10.2011
Erschienen in
European Radiology / Ausgabe 10/2011
Print ISSN: 0938-7994
Elektronische ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-011-2147-x

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