Clinical Application Of Volume CT Digital Subtraction Angiography In Intracranial Aneurysms

PART 1 RELATIONSHIP BETWEEN THE GENERATION OF INTRACRANIAL COMMUNICATING ARTERY ANEURYSMS AND THE VARIATIONS OF CIRCLE OF WILLISObjective: To explore the relationship between the generation of anterior and posterior communicating artery aneurysms and the variations of circle of Willis by volume computed tomography digital subtraction angiography (VCTDSA) with 64-channel multidector row CT.Materials and methods: In the blind retrospective study, the imaging data of 204 patients(81 men, 123 women, age range from 16 to 77 years, with the mean of 54.29±12.66) were reviewed and divided into three groups, which is ACoAA, PCoAA, control group of non-aneurysm. In the former two groups, the gender, age and angle of major diameter of aneurysms to corresponding blood flow were measured. Compared to the control group, the relationship between the generation of communicating artery aneurysms and variations of the circle of Willis was observed.Results: In 24 cases of ACoAA , 63 of PCoAA and 117 of non-aneurysm, there was no significant difference in age but angle and gender, which showed that more men suffered from ACoAA, more women PCoAA. Compared to the control group, there was no significant difference in variations of the circle of Willis of the group of PCoAA but ACoAA.Conclusions: It is showed that there is relationship between the generation of ACoAA and hemodynamics of the circle of Willis, no obvious relationship between the generation of PCoAA and hemodynamics of the circle of Willis, and the two kind of aneurysms go to different genders.PART 2 COMPARISON OF VCTDSA AND 3D TOF MRA IN THE DIAGNOSIS OF INTRACRANIAL ANEURYSMSObjective: To evaluate the diagnostic value and comparison of volume computed tomography digital subtraction angiography (VCTDSA) with 64-channel multidector row CT and three dimensional time-of-flight magnetic resonance angiography (3D TOF MRA) in intracranial aneurysms.Materials and methods: In the blind retrospective study, the imaging data of 33 patients with suspected aneurysms were analyzed and diagnosed by DSA and/or surgery. The angiograms were interpreted by the presence, location, size of aneurysms and relationship of the aneurysms with the adjacent arterial branches (the image quality), as well as the sensitivity and specificity, by using 3D volume rendering techniques.Results: In 41 aneurysms of 33 patients, the overall sensitivity and specificity of VCTDSA on a per-aneurysm basis were 89.13% and 100.0% respectively, and those of 3D TOF MRA were 80.0% and 50.0% respectively. Compared with 3D TOF MRA, there was no significant difference in the size of detected aneurysms and relationship between the aneurysms and parent arteries by both two angiographies, but with a higher rank of image quality and better display of small vessels in VCTDSA.Conclusions: VCTDSA is a fast and reliable technique, which can be the primary choice in the detection and characterization of intracranial aneurysms. And 3D TOF MRA can be complementary for patients with contraindications of VCTDSA.