A Comparative Study 2D-DSA, 3D-DSA And CTA In Diagnosis Of Intracranial Aneurysms

Objective:Cerebrovascular angiography through the two-dimensional digital subtraction angiography (2D-DSA) and cerebrovascular angiography three-dimensio-nal digital subtraction angiography (3D-DSA) and CT angiography (CTA) for the detection of intracranial aneurysms and aneurysms neck visibility and the relationship between the location of the parent artery of contrast research, evaluation of2D-DSA,3D-DSA and CTA to assess the diagnostic value of three methods for intracranial aneurysm.Methods:Fifty patients were diagnosed spontaneous subarachnoid hemorrhage(SAH) By computed tomography(CT) scan, and were examined with2D-DSA,3D-DSAandCTA. CTA was Performed with GE Light Speed VCT64-row scanners, and GE AW4.4workstation. Scan parameters:tube voltage120kV, tube current of300mA, pitch1.375:1, slice thickness0.625mm the scanning speed0.4s/week Scan range from the parietal to the base of the skull5cm, first brain unenhanced, and then use high-pressure syringe cubital intravenous bolus injection of non-ionic contrast agent Ultravist (370mg/ml) injection after injection of saline20ml of then injected rate:4to5ml/s, reconstruction interval0.625mm the data obtained reached the AW4.4workstation, this study using volume rendering the law (VR).2D-DSA check using Philip Allura Xper FD20digital subtraction angiography machine. Through the Seldinger technique of femoral artery puncture, intubation, selective guide to bilateral common carotid artery and bilateral vertebral arteries, using non-ionic contrast Ultravist (350mg/ml), internal carotid artery5ml/s flow rate, total9ml,4ml/s vertebral artery flow rate, total8ml. Photo taken and lateral vascular angiography, plus oblique film when necessary.3D-DSA checking using c-arm rotate180°,6frames per second,512x512matrix. Injection flow rate:internal carotid artery5ml/s, total9ml, vertebral artery4ml/s, total8ml. Image acquisition and data transmission to AW4.4station rebuilding, reconstruction after the90s out of the3D-DSA image. Reconstruction method using volume rendering display (VR). The x2test fourfold table was used to compare2D-DSA,3D-DSA with CTA for diagnosis rate of aneurysm. Row by line x2test was used to compare the relationship between aneurysm neck and parent vessels. P rate of less than0.05shows significantly statistical difference.Results:Fourty-six patients were diagnosed with intracranial aneurysms, and55intracranial aneurysms were detected, anterior communicating artery aneurysms were12cases, Internal carotid-posterior communicating artery aneurysms were28cases, aneurysms in bifurcation of middle cerebral artery were10cases, basilar apex artery aneurysm Was1case, posterior cerebral artery aneurysm Was1case, and carotid-ophthalmic artery aneurysms were3cases. The positive rate of3D-DSA for definite aneurysm diagnosis Was100%, and CTA89.1%,2D-DSA87.3%, respectively. Comparison of2D-DSA and CTA shows P>0.05, which means no statistical difference. Comparison of3D-DSA and CTA shows P<0.05, which means statistical difference. The result shows3D-DSA is better.than CTA in accurate diagnosis rate of aneurysm. Comparison of2D-DSA and CTA in the relationship between aneurysm neck and parent vessel shows P<0.01, which means statistical difference, showing that CTA is better than2D-DSA in demonstrating the relationship between aneurysm neck and parent vessel. Comparison of3D-DSA and CTA shows P<0.01, which means statistical difference showing that3D-DSA is better than CTA in demonstrating the relationship between aneurysm neck and parent vessel.Conclusion:3D-DSA has more advantages over CTA in the early diagnosis of intracranial aneurysms, while CTA was better than2D-DSA.3D-DSA has the status of gold value in aneurysm diagnosis, especially in revealing a small aneurysm and demonstrating the relationship between aneurysm neck and parent vessel.2D-DSA has false positive and false negative results, so it should use multi-angle radiation to find aneurysm, especially in the hospital not having3D-DSA machine. CTA may more easily be received by the patients because of its non-invasiveness. CTA probably will have an extensive future application in early screening of intracranial aneurysm and its operational follow-up. CTA has more value in aneurysms with evident thrombosis.