Detectability of cerebral aneurysms and efficacy of surgical simulation by helical CT compared with conventional cerebral angiography.
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The usefulness of helical CT for detecting intracranial aneurysms was evaluated. The diagnostic accuracy of helical CT was compared with that of conventional cerebral angiography in 83 aneurysms of 64 patients. The scanning parameters were 135 KV, 250 mA and a 1-mm slice thickness. The couch top was moved at 1-2 m/s during the scanning of 30s. For postprocessing, 3-D CT images by a volume-rendering technique and MPR images were provided using a work station. The detection rates by helical CT and angiography were 96.4% and 97.6%, respectively. Helical CT was superior to conventional angiograms in its multi-directional display of the circle of Willis, including base view projections for visualizing small aneurysms such as blister-like aneurysms or aneurysms surrounded by complicated arteries and thrombosed aneurysms. All aneurysms located above the anterior clinoid process could be observed retrospectively. The smallest aneurysms with a diameter of 1-2 mm were demonstrated by this technique. Multiple reconstruction images provided information on the intra-aneurysmal thrombous or calcified parts and associated vascular anomlies. Conventional angiograms were superior to helical CT in revealing intraclinoid small aneurysms with a diameter of less than 6 mm and perforating branches of less than 1 mm in diameter. With respect to larger aneurysms with diameters of over 12 mm, helical CT tended to be more useful than conventional angiography for delineating the aneurysmal blebs, neck and orifice of the aneurysms, as well as the relation to the surrounding vessels. From the standpoint of preoperative simulation, helical CT provided useful information on the anatomical relationship with the parent artery, inner view of the aneurysm and bony structures around the aneurysm. From the neurosurgical viewpoint, helical CT is considered more useful than conventional angiography for delineating intracranial aneurysms.
- 一般社団法人 日本脳卒中学会の論文
一般社団法人 日本脳卒中学会 | 論文
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