Study Of The Ability In Detecting Intracranial Hematoma With C-Arm Cone-Beam CT

PART 1:Experimental Study of Measuring Cerebral Hemorrhage with C-arm Cone-beam Computed TomographyObjective:To explore the ability of measuring cerebral hemorrhage volume by the method of C-arm cone-beam computed tomography(Dyna CT).Methods :The mixture of contrast agent and water was packaged with small balloon simulated intracranial hematoma, then divided into 9 groups by the volume. Each group received 3 times scanning by MSCT and 3 times scanning by Dyna CT, and MPR images were reconstructed, all the volume were measured in the Siemens Volume Measurement software, and calculated the degree of deviation and did statistical analysis.Results:When the shape of hematoma was regular, the accuracy of measuring volume with Dyna CT was high, the results didn’t show a significant difference(P valued<0.05) compared to actual volume and MSCT; when the shape of hematoma was irregular, there was some error compared to actual volume when the volume was less than or equal to 20 ml and greater than or equal to 70 ml,the results showed a significant difference(P valued<0.05);When the volume was between 30 ml and 60 ml,the measurement of volume in Dyna CT was equal to the actual volume, the results didn’t show a significant difference(P valued<0.05);The accuracy of measuring cerebral hemorrhagr with MSCT was higher than Dyna CT(P valued<0.05).Conclusion:The reasonable choice of quantitative detection range of intracranial hematoma with C-arm cone beam CT could be effectively applied to the monitoring of the intracranial hemorrhage during interventional diagnosis and treatment. PART 2:Detection of intracranial hematoma with different density using C-arm Cone-beam Computed Tomography based on animal modelObjective : To evaluate the ability of detecting intracranial hematomas with different density by using C-arm Cone-beam computed tomography(Dyna CT) in canine models.Methods:Fourteen healthy canines were divided into seven groups and each group has two animals, blood and contrast agent(3ML) were slowly injected into the left/right frontal lobes of each animal.CT value of the mixture in group two to seven was 60~65,65~70,70~75,75~80,80~85,85~90HU respectively.As the control group,the frist group was injected into autologous blood without contrast agent.We scanned each animal by using Dyna CT and multislice computed tomography(MSCT)after 5 minutes,the attenuation values and their standard deviations of the hematoma and uniformed brain tissues were measured to calculate the image noise,signal to noise ratio(SNR)and contrast to noise ratio(CNR).and use Bland-Altman to evaluate the coherence of results in two methods;A scale with scores 1~3 was used to rate the quality of the reconstructed image of different hematoma as a subjective evalution,the Kappa value was used to evalute the coherence between the grades of two doctors,the difference among the evalution scores were analyzed using Kruskal-wallis.Results:The coherence between SD、SNR、CNR in Dyna CT and MSCT was reliable;The coherence between the grades of two doctors were very reliable;and with the decreasing of the density,the subjective evalution scores of Dyna CT was decreased,when the density was under 65 HU,the Dyna CT could not find hematoma;and when the density was exceed 65 HU,the scores of two techinques were fairly,and the results showed significant diffenence(Z valued-3.16,p valued<0.05).Conclusion The reasonable choice of density detection range of intracranial hematoma with Dyna CT could be effectively applied to monitoring the intracranial hemorrhage during interventional diagnosis and treatment.