The Clinical Applications For Three Dimensional Rotational Angiography And C-Arm Computed Tomography With Flat Panael Detector In Cerebral Aneurysms

Objective:To evaluate the clinical applications for three dimensional rotational angiography(3DRA) and c-arm computed tomography with flat panel detector in cerebral aneurysms.Materials and Methods:From August 2007 to January 2009,72 patients diagnosed as intracranial aneurysm underwent 2-dimensional digital subtracted angiography (2D DSA) and 3DRA with flat panel detector. After 3DRA examination,VR,SSD,MIP,GR,and Sum were performed by 3DRA workstation. The differences between VR,SSD,MIP,GR,Sum and 2D DSA in aneurysm detection,neck and shape of aneurysm and the relationship between the aneurysms and their parent arteries were compared. The dose of radiation exposure and the using volume of contrast agent were compared between 2D DSA and 3DRA in 30 patients . 6 patients suspected aneurysm rupture during procedures underwent c-arm computed tomography immediately,in order to find the intracranial hemorrhage;1 patient underwent C-arm CT following intravenous contrast medium administration.Results Of all the 72 patients, eighty-six aneurysms were detected in 65 patients. 74 aneurysms were visualized by 2D DSA, and 3DRA shown 86 aneurysms. Therefore 3DRA was significantly superior to 2D DSA in detection of aneurysms in the visualization of aneurysms (P<0.0001). The shapes of 10 aneurysms were displayed on 2D DSA , and the shapes of 86 aneurysms were well displayed on 3DRA . So 3DRA was significantly superior to 2 D DSA in the visualization of aneurysm shapes (P<0.0001). The necks of 17 aneurysms were demonstrated on 2D DSA, and 86 were observed on 3DRA. So 3DRA was significantly superior to 2D DSA in the visualization of aneurysm neck (P<0.0001) .The relationship between the 11 aneurysms and their carrying arteries were seen on 2D DSA, 86 of which were well depicted on 3DRA.Therefore , 3DRA was significantly superior to 2D DSA in detection of relationship between the aneurysms and their parent arteries.30 patients was analyzed, the aneurysms were marked up with blueness, and 18 of them were performed volume measurement. The aneurysms from 5 of them were detached from the parent artery;3 basilar artery aneurysms were performed virtual stent technology; 5patients with aneurysms were simulated the modeling of catheter tip in endovascular embolization. Small perforator arteries from aneurysmal neck of 5 patents and plaque and thrombosis from aneurysmal cavity of 8 patients were detected by VA. The dose of radiation exposure and the using volume of contrast agent by 2D DSA were much larger than 3DRA (P<0.0001).6 patients suspected aneurysm underwent C-arm CT, and 1 of them were found to have SAH. 1 patient underwent C-arm CT following intravenous contrast medium administration, and C-arm CT clearly demonstrated the cerebral arteries and aneurysm.Conclusions:The 3DRA can significantly increase the diagnostic accuracy of cerebral aneurysm,and it is quite valuable for diagnosis during interventional embolic procedures pertaining to cerebral aneurysms.Therefore,implementation of 3DRA is an extremely useful tool in the treatment of cerebral aneurysms. The dose of radiation exposure and the using volume of contrast agent by 3DRA are lower than 2D DSA. 3DRA is regarded as the new gold standard in the detection of additional intracranial aneurysms.more sensitive in detecting intracranial aneurysms, by which aneurismal shape, aneurismal size, growth direction, the width and length of aneurysm and adjacent vessels can be revealed clearly. It is quite valuable for treatment plan.Aneurysmal Analysis has provided a guarantee of success for endovascular embolization of aneurysm , and also reduced the occurrence of complications. C-arm CT could immediately find complications during interventional procedure simplify the treatment process, conducive to good therapeutic effect.