Assessing the quality of angiographic display of brain blood vessels aneurysms compared to intraoperative state

  • Igor Miroslav Nikolić Clinic of Neurosurgery, Clinical Center of Serbia, Belgrade, Serbia; Faculty of Medicine, University of Belgrade, Belgrade, Serbia
  • Goran M Tasić Clinic of Neurosurgery, Clinical Center of Serbia, Belgrade, Serbia; Faculty of Medicine, University of Belgrade, Belgrade, Serbia
  • Vladimir T Jovanović Clinic of Neurosurgery, Clinical Center of Serbia, Belgrade, Serbia; Faculty of Medicine, University of Belgrade, Belgrade, Serbia
  • Nikola R Repac Clinic of Neurosurgery, Clinical Center of Serbia, Belgrade, Serbia
  • Aleksandar M Janićijević Clinic of Neurosurgery, Clinical Center of Serbia, Belgrade, Serbia
  • Vuk D Šćepanović Clinic of Neurosurgery, Clinical Center of Serbia, Belgrade, Serbia
  • Branislav D Nestorović Clinic of Neurosurgery, Clinical Center of Serbia, Belgrade, Serbia. Faculty of Medicine, University of Belgrade, Belgrade, Serbia
Keywords: intracranial aneurysm, diagnosis, angiography, tomography, x-ray computed, magnetic resonance angiography, digital subtraction,

Abstract


Background/Aim. Aneurysms in brain blood vessels are expanding bags composed of a neck, body and fundus. Clear visibility of the neck, the position of the aneurysm and surrounding structures are necessary for a proper choice of methods for excluding the aneurysm from the circulation. The aim of this study was to evaluate the reliability of spatial reconstruction of blood vessels of the brain based on the original software for 3D reconstruction of the equipment manufacturer and a personal computer model developed earlier in the Clinic for Neurosurgery, Clinical Center of Serbia, Belgrade, compared to intraoperative identification of these aneurysms. Methods. This study included 137 patients of both sexes. The presence of an aneurysm was verified by angiographic methods [computed tomographic angiography (CTA), multislice computed tomography angiography (MSCTA), magnetic resonance imaging angiography (MRA), or digital subtraction angiography (DSA)]. Results. The quality score (0 to 5) for CTA was 3.180 ± 0.961, MSCTA 4.062 ± 0.928, and for DSA 4.588 ± 0.758 (p < 0.01). The results of this study favorite conventional angiography as the gold standard for diagnostic of intracranial aneurysms.  Conclusion. The results of this study are consistent with current publications review and clearly recognize the advantages and disadvantages of diagnostic neuroradiological procedures, with DSA of brain blood vessels as a binding preoperative diagnostic procedure in cases in who it is not possible to clearly visualize the supporting blood vessel and neck of the aneurysm by using the findings of CTA, MRA and MSCTA.

 

 


References

Kato Y, Nair S, Sano H, Sanjaykumar MS, Katada K, Hayakawa M, et al. Multi-slice 3D-CTA - an improvement over single slice helical CTA for cerebral aneurysms. Acta Neruochir (Wien) 2002; 144(7): 715−22.

Morhard D, Ertl-Wagner B. MDCT in Neuro-Vascular Imaging. In: Reiser MF, Becker, Nikolaou K, Glazer G, editors. Multi-Slice CT. Berlin: Springer-Verlag; 2009. p. 123−36.

Wolf RL. CT Imaging and Physiologic Techniques in Interven-tional Neuroradiology. In: Hurst RW, Rosenwasser RH, editors. Interventional neuroradiology. New York: Informa Health-care; 2008. p. 87−111.

Kato Y, Sano H, Katada K, Ogura Y, Hayakawa M, Kanaoka N, et al. Application of three-dimensional CT angiography (3D-CTA) to cerebral aneurysms. Surg Neurol 1999; 52(2): 113−21.

Kato Y, Hayakawa M, Katada K. Three-dimensional multislice helical CT angiography of cerebral aneurysms. Nippon Rinsho 2004. 62(4): 715−21. (Japanese)

Matsumoto M, Sato M, Nakano M, Endo Y, Watanabe Y, Sasaki T, et al. Three-dimensional computerized tomography angiography-guided surgery of acutely ruptured cerebral aneurysms. J Neurosurg, 2001; 94(5): 718−27.

Matsumoto M, Endo Y, Sato M, Sato S, Sakuma J, Konno Y, et al. Acute aneurysm surgery using three-dimensional CT angiogr-phy without conventional catheter angiography. Fukushima J Med Sci 2002. 48(2): 63−73.

Kornienko VN, Pronin IN. Diagnostic Neuroradiology. Berlin: Springer-Verlag; 2009:

Sugahara T, Korogi Y, Nakashima K, Hamatake S, Honda S, Taka-hashi M. Comparison of 2D and 3D digital subtraction an-giography in evaluation of intracranial aneurysms. AJNR Am J Neuroradiol 2002; 23(9): 1545−52.

Manabe H, Takemura A, Hasegawa S, Nagahata M, Iko Y. Ex-travasation from Rupturing Aneurysm Demonstrated by 3D Digital Subtraction Angiography. AJNR Am J Neuroradiol, 2005; 26(6): 1370−1.

Asir A, Guven G, Tekin T, Kutlay M, Colak A, Simsek H, et al. Three-dimensional versus conventional digital subtraction an-giography in the diagnosis of intracranial aneurysms: case re-port. Balkan Military Medical Review 2007; 10: 147−9.

Huston J 3rd. Magnetic Resonance Angiography. In: Winn RH, editor. Youman`s Neurological Surgery. Philadelphia: Saun-ders; 2004. p. 1575−99.

Huston J 3rd, Torres VE, Sulivan PP, Offord KP, Wiebers DO. Value of magnetic resonance angiography for the detection of intracranial aneurysms in autosomal dominant polycystic kid-ney disease. J Am Soc Nephrol 1993. 3(12): 1871−7.

Hughes DG. Neuroradiology and Ultrasound. In: Moore AJ, Newell DV, editor. Neurosurgery: Principles and Practice. London: Springer; 2005. p. 23−8.

Anzalone N, Scomazzoni F, Cirillo M, Righi C, Simionato F, Cadioli M, et al. Follow-up of coiled cerebral aneurysms at 3T: comparison of 3D time-of-flight MR angiography and contrast-enhanced MR angiography. AJNR Am J Neuroradiol 2008; 29(8): 1530−6.

Huston J 3rd, Lewis BD, Wiebers DO, Meyer FB, Riederer SJ, Weaver AL. Carotid artery: prospective blinded comparison of two-dimensional time-of-flight MR angiography with conven-tional angiography and duplex US. Radiology 1993; 186(2): 339−44.

Huston J 3rd, Ehman RL. Comparison of time-of-flight and phase-contrast MR neuroangiographic techniques. Radio-graphics 1993; 13(1): 5−15.

Berisavac I, Bojović V, Bizjak B, Ateljević M, Bićanin G. Intracra-nial aneurysmal bleeding. Subotica: Biografika; 1998. (Serbian)

Satoh T. Delineation of cerebral aneurysms with fly-through imaging of 3D-MRA using perspective volume rendering. No Shinkei Geka 2001; 29(2): 181−6. (Japanese)

Watanabe Z, Kikuchi Y, Izaki K, Hanzu N, Gotou H, Koizumi J, et al. The usfulness of 3D MR angiography in surgery for ruptured cerebral aneurysms. Surg Neurol 2001; 55(6): 359−64.

Nikolić IM. Computer-assisted spatial reconstruction of cere-bral blood vessels and intra cranial aneurysms. Med Pregl 2006; 59(1−2): 24−7. (Serbian)

Nikolić IM. The application of mathematical modeling in the preoperative preparation of patients with cerebrovascular mal-formations - aneurysms. Belgrade: Faculty of Medicine, Uni-versity of Belgrade; 2003. (Serbian)

Villablanca JP, Hooshi P, Martin N, Jahan R, Duckwiler G, Lim S, et al. Three-dimensional helical computerized tomography angiography in the diagnosis, characterization, and management of middle cerebral artery aneurysms: comparison with conventional angiography and intraoperative findings. J Neurosurg 2002; 97(6): 1322−32.

Dehdashti AR, Rufenacht DA, Delavelle J, Reverdin A, de Tribolet N. Therapeutic decision and management of aneurysmal su-barachnoid haemorrhage based on computed tomographic an-giography. Br J Neurosurg 2003; 17(1): 46−53.

Schuknecht B. High-concentration contrast media (HCCM) in CT angiography of the carotid system: impact on therapeutic decision making. Neuroradiology 2007; 49(Suppl 1): S15−26.

Li Q, Lv F, Li Y, Li K, Luo T, Xie P. Subtraction CT angiography for evaluation of intracranial aneurysms: comparison with conventional CT angiography. Eur Radiol 2009; 19(9): 2261−7.

González-Darder JM, Pesudo-Martínez JV, Feliu-Tatay RA. Microsurgical management of cerebral aneurysms based in CT angiography with three-dimensional reconstruction (3D-CTA) and without preoperative cerebral angiography. Acta Neruochir (Wien) 2001; 143(7): 673−9.

Meyer RE, Nickerson JP, Burbank HN, Alsofrom GF, Linnell GJ, Filippi CG. Discrepancy rates of on-call radiology residents' in-terpretations of CT angiography studies of the neck and circle of Willis. AJR Am J Roentgenol 2009; 193(2): 527−32.

Livingston RR. Regarding the Risk of Death from CT An-giography in patients with Subarachnoid Hemorrhage. AJNR Am J Neuroradiol 2008; 29(6): e44; author reply e46−7.

Karamessini MT, Kagadis GC, Petsas T, Karnabatidis D, Konstanti-nou D, Sakellaropoulos GC, et al. CT angiography with three-dimensional techniques for the early diagnosis of intracranial aneurysms. Comparison with intra-arterial DSA and the surgi-cal findings. Eur J Radiol 2004; 49(3): 212−23.

Romijn M, Gratama van Andel HA, van Walderveen MA, Sprengers ME, van Rijn JC, van Rooij WJ, et al. Diagnostic accuracy of CT angiography with matched mask bone elimination for detection of intracranial aneurysms: comparison with digital subtraction angiography and 3D rotational angiography. AJNR Am J Neuroradiol 2008; 29(1): 134−9.

Li Q, Lv F, Li Y, Luo T, Li K, Xie P. Evaluation of 64-section CT angiography for detection and treatment planning of in-tracranial aneurysms by using DSA and surgical findings. Ra-diology 2009; 252(3): 808−15.

McKinney AM, Palmer CS, Truwit CL, Karagulle A, Teksam M. Detection of aneurysms by 64-section multidetector CT an-giography in patients acutely suspected of having an intracra-nial aneurysm and comparison with digital subtraction and 3D rotational angiography. AJNR Am J Neuroradiol 2008; 29(3): 594−602.

Watanabe Y, Uotani K, Nakazawa T, Higashi M, Yamada N, Hori Y, et al. Dual-energy direct bone removal CT angiography for evaluation of intracranial aneurysm or stenosis: comparison with conventional digital subtraction angiography. Eur Radiol 2009; 19(4): 1019−24.

Watanabe Y, Kashiwagi N, Yamada N, Higashi M, Fukuda T, Morikawa S, et al. Subtraction 3D CT angiography with the or-bital synchronized helical scan technique for the evaluation of postoperative cerebral aneurysms treated with cobalt-alloy clips. AJNR Am J Neuroradiol 2008; 29(6): 1071−5.

Amagasaki K, Takeuchi N, Sato T, Kakizawa T, Shimizu T. Cur-rent usage of three-dimensional computed tomography an-giography for the diagnosis and treatment of ruptured cerebral aneurysms. J Clin Neurosci 2004; 11(5): 481−5.

Agid R, Willinsky RA, Farb RI, Terbrugge KG. Life at the end of the tunnel: why emergent CT angiography should be done for patients with acute subarachnoid hemorrhage. AJNR Am J Neuroradiol 2008. 29(6): e45; author reply e46−7.

Fox AJ, Symons SP, Aviv RI. CT angiography is state-of-the-art first vascular imaging for subarachnoid hemorrhage. AJNR Am J Neuroradiol 2008; 29(6): e41−2.

Erdem Y, Yilmaz A, Ergün E, Koşar U, Karatay M, Bayar MA. Bilateral internal carotid artery hypoplasia and multiple poste-rior circulation aneurysms. Importance of 3DCTA for the diagnosis. Turk Neurosurg 2009; 19(2): 168−71.

Pechlivanis I, Harders A, Tuttenberg J, Barth M, Schulte-Altedorneburg G, Schmieder K. Computed tomographic angiogra-phy: diagnostic procedure of choice in the management of su-barachnoid hemorrhage in the elderly patient? Cerebrovasc Dis 2009; 28(5): 481−9.

Chen W, Yang Y, Qiu J, Peng Y, Xing W. Clinical application of 16-row multislice computed tomographic angiography in the preoperative and postoperative evaluation of intracranial aneurysms for surgical clipping. Surg Neurol 2009; 71(5): 559−65.

Weyerbrock A, Woznica M, Rosahl SK, Berlis A. Aneurysmal and Non-Aneurysmal SAH - Is Initial Computed Tomography Predictive? Rofo 2009; 181(9): 881−7.

van Rooij SB, van Rooij WJ, Sluzewski M, Sprengers ME. Fenestrations of intracranial arteries detected with 3D rota-tional angiography. AJNR Am J Neuroradiol 2009; 30(7): 1347−50.

de Gast AN, van Rooij WJ, Sluzewski M. Fenestrations of the anterior communicating artery: incidence on 3D angiography and relationship to aneurysms. AJNR Am J Neuroradiol 2008; 29(2): 296−8.

van Rooij WJ, Peluso JP, Sluzewski M, Beute GN. Additional Value of 3D Rotational Angiography in Angiographically Negative Aneurysmal Subarachnoid Hemorrhage: How Negative is Negative? AJNR Am J Neuroradiol 2008; 29(5): 962−6.

van Rooij WJ, Sprengers ME, de Gast AN, Peluso JP, Sluzewski M. 3D rotational angiography: the new gold standard in the detection of additional intracranial aneurysms. AJNR Am J Neuroradiol 2008; 29(5): 976−9.

Hai J, Deng DF, Chen ZQ, Pan QG. Endovascular embolization of small ruptured intracranial aneurysms using a biplane an-giographic system with three-dimensional rotational digital subtraction angiography. J Clin Neurosci 2009; 16(8): 1028−33.

Hirai T, Korogi Y, Ono K, Yamura M, Uemura S, Yamashita Y. Pseudostenosis phenomenon at volume-rendered three-dimensional digital angiography of intracranial arteries: fre-quency, location, and effect on image evaluation. Radiology 2004; 232(3): 882−7.

Kakeda S, Korogi Y, Ohnari N, Hatakeyama Y, Moriya J, Oda N, et al. 3D digital subtraction angiography of intracranial aneu-rysms: comparison of flat panel detector with conventional image intensifier TV system using a vascular phantom. AJNR Am J Neuroradiol 2007; 28(5): 839−43.

Nikolić I, Milovanović D, Antunović V, Stanković S. The Evalua-tion of Computer Based 3-D Reconstruction of MCA Aneu-rysms. J Automatic Control 2005; 15(Suppl): 35−7.

Nikolić IM, Nagulić M, Antunović V. Significance of the spatial reconstruction based on mathematical modeling in the surgical treatment of giant intracranial aneurysms. Vojnosanit Pregl 2006; 63(1): 65−8. (Serbian)

Nikolić IM, Rakić MLj, Slavik EE, Tasić GM, Đurović BM, Jovanović VT, et al. Space reconstruction of the aneurysms of the vertebrobasilary confluence based on conventional an-giography-our experience. Acta Chir Iugosl 2008; 55(2): 75−8. (Serbian)

Schwab KE, Gailloud P, Wyse G, Tamargo RJ. Limitations of magnetic resonance imaging and magnetic resonance an-giography in the diagnosis of intracranial aneurysms. Neuro-surgery 2008; 63(1): 29−35.

Piotin M, Gailloud P, Bidaut L, Mandai S, Muster M, Moret J, et al. CT angiography, MR angiography and rotational digital subtraction angiography for volumetric assessment of intracranial aneurysms. An experimental study. Neuroradiology 2003; 45(6): 404−9.

Jou LD, Mohamed A, Lee DH, Mawad ME. 3D rotational digital subtraction angiography may underestimate intracranial aneurysms: findings from two basilar aneurysms. AJNR Am J Neuroradiol 2007; 28(9): 1690−2.

Fox AJ, Millar J, Raymond J, Pryor JC, Roy D, Tomlinson GA, et al. Dangerous Advances in Measurements from Digital Sub-traction angiography: When Is a Milimeter Not a Milimeter? AJNR Am J Neuroradiol 2009; 30(3): 459−61.

Kawashima M, Kitahara T, Soma K, Fujii K. Three-dimensional digital subtraction angiography vs two-dimensional digital sub-traction angiography for detection of ruptured intracranial an-eurysms: A study of 86 aneurysms. Neurol India 2005; 53(3): 287−9; discussion 290.

Beck J, Rohde S, Berkefeld J, Seifert V, Raabe A. Size and location of ruptured and unruptured intracranial aneurysms measured by 3-dimensional rotational anegiography. Surg Neurol 2006; 65(1): 18−25.

Raabe A, Beck J, Rohde S, Berkefeld J, Seifert V. Three-dimensional rotational angiography guidance for aneurysm surgery. J Neurosurg 2006; 105(3): 406−11.

Willems PW, van Walsum T, Woerdeman PA, van de Kraats EB, de Kort GA, Niessen WJ, et al. Image-guided vascular neurosurgery based on three-dimensional rotational angiography. Technical note. J Neurosurg 2007; 106(3): 501−6.

Pierot L, Delcourt C, Bouquigny F, Breidt D, Feuillet B, Lanoix O, et al. Follow-up of intracranial aneurysms selectively treated with coils: Prospective evaluation of contrast-enhanced MR angiography. AJNR Am J Neuroradiol 2006; 27(4): 744−9.

Majoie CB, Sprengers ME, van Rooij WJ, Lavini C, Sluzewski M, van Rijn JC, et al. MR angiography at 3T versus digital subtrac-tion angiography in the follow-up of intracranial aneurysms treated with detachable coils. AJNR Am J Neuroradiol 2005; 26(6): 1349−56.

Thornton J, Debrun GM, Aletich VA, Bashir Q, Charbel FT, Aus-man J. Follow-up angiography of intracranial aneurysms treated with endovascular placement of Guglielmi detachable coils. Neurosurgery 2002; 50(2): 239−50.

Kakeda S, Korogi Y, Hiai Y, Sato T, Ohnari N, Moriya J, et al. MRA of intracranial aneurysms embolized with platinum coils: a vascular phantom study at 1.5T and 3T. J Magn Reson Imag-ing 2008; 28(1): 13−20.

Hiai Y, Kakeda S, Sato T, Ohnari N, Moriya J, Kitajima M, et al. 3D TOF MRA of intracranial aneurysms at 1.5 T and 3 T: in-fluence of matrix, parallel imaging, and acquisition time on image quality - a vascular phantom study. Acad Radiol 2008; 15(5): 635−40.

Mönninghoff C, Maderwald S, Theysohn JM, Kraff O, Ladd SC, Ladd ME, et al. Evaluation of intracranial aneurysms with 7 T versus 1.5 T time-of-flight MR angiography - initial experience. Rofo 2009; 181(1): 16−23.

Gibbs GF, Huston J 3rd, Bernstein MA, Riederer SJ, Brown RD Jr. Improved image quality of intracranial aneurysms: 3.0-T versus 1.5-T time-of-flight MR angiography. AJNR Am J Neuroradiol 2004; 25(1): 84−7.

Hiratsuka Y, Miki H, Kiriyama I, Kikuchi K, Takahashi S, Matsu-bara I, et al. Diagnosis of unruptured intracranial aneurysms: 3T MR angiography versus 64-channel multi-detector row CT angiography. Magn Reson Med Sci 2008; 7(4): 169−78.

Published
2017/01/20
Section
Original Paper