| Objective:Evaluate the clinical value of dual-source Flash CT (Somatom Definition Flash) in patients with cerebral aneurysms.Materials and methods:Sixty-six patients with suspected cerebral arterial diseases were underwent dual-source Flash CT angiography, There were35males and31females, mean age62±11years (age range:2-84y). Twenty-six patients were confirmed by DSA.CTA were performed on a second generation dual-source CT (Somatom Definition Flash) in dual-energy mode, scanning range was determined by topology, and the scan range of CT cerebral angiography extended from the base of skull to the level of the aortic arch (or mandible). Data was acquired in the caudocranial direction. A dual-head power injector was used. The contrast medium was iohexol (350mgI/ml). A total volume of50-70ml of contrast medium and50ml of saline were injected at the same rate (5.0-5.5ml/s) via right ante-cubital vein. Bolus-tracking was applied with a region-of-interest (ROI) in the ascending aortic root level or left internal carotid artery, after reaching the preset contrast enhancement level of100Hu in the ROI, the scan was initiated automatically after a delay of2s.The raw data from two tubes generated3image datasets (80kV,140kV and fused average weighted images). These datasets were processed by dedicated dual energy bone removal software on a multiple workplace. the "Head Bone Removal" mode was carried out, the processed bone-removal images were further reconstructed with maximum intensity projection (MIP), multiplanar reformation (MPR) and volume rendering (VR) respectively for data analysis.The location, number, shape, size of aneurysms and the relationship between aneurysms with parent arteries were evaluated by two experienced radiologists independently without knowledge on DSA. Compared with DSA, the diagnostic efficiency of CTA was evaluated.Statistical analysis was performed using SPSS19.0software, using the paired t test to compare pairs of source Flash DE-CTA and DSA measuring intracranial aneurysm size, number, with P<0.05was considered statistically significant. Compare aneurysm long axis, short axis and neck size, P>0.05, there was no statistically significant difference between the two.Results:Of the66patients who participated in this study,87aneurysms were found by CTA. Forty-nine cases with single aneurysm,13cases with two aneurysms and4cases with3aneurysms; 27aneurysms with narrow necks,35aneurysms with wide necks and25aneurysms were fusiformis. Forty-nine aneurysms located in internal carotid arteries,4in vertebral arteries,5in basilar arteries,7in anterior cerebral arteries,13in middle cerebral arteries,5in posterior cerebral arteries,3in anterior communicating arteries,1in posterior communicating artery.26patients were confirmed by DSA,29aneurysms were found, DSA found that30(there is one case of anterior communicating artery aneurysm due to tumor smaller, CTA not detected), diagnosis rate was96.7%. Diagnosis of23cases of patients with a single aneurysm, three cases of two patients with aneurysms. Location and quantity:the last paragraph8of the internal carotid artery, the anterior cerebral artery5,7middle cerebral artery, posterior cerebral artery2,3anterior communicating artery, posterior communicating artery1, last paragraph two vertebral artery, basal an artery. Size: aneurysm diameter minimum2.23mm, the maximum diameter of26.71mm; forms:narrow basilar artery aneurysm16, wide base7, spindle6.Conclusions:FlashCT using dual-energy dual-source CTA get thin MIP, VR thin and overall MIP, MPR and other restructuring and overall VR image, various image have their advantages, also its shortcomings, combined with a variety of post-processing methods can be fully clearly show the aneurysm neck and characteristics of the tumor, effectively positioning guide clinical surgery and surgical planning, and is a noninvasive, fast, safe, accurate and reliable, it is worth checking methods of clinical use. |
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