Dual-Energy CT Angiography in the Evaluation of Intracranial Aneurysms: Image Quality, Radiation Dose, and Comparison With 3D Rotational Digital Subtraction Angiography

Zhang, Long Jiang; Wu, Sheng; Niu, Jing Bo; Zhang, Zhuo Li; Zhao, Yan; Xue, Cheng; Zhou, Chang Sheng; Lu, Guang Ming

doi:10.2214/ajr.08.2290

Cited by 101 publications

(61 citation statements)

References 31 publications

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“…Our findings are concordant with those in previous reports [8][9][10][11] and compare well with a meta-analysis of twelve 16 -detector row BSCTA studies. 10 The sensitivity and specificity of BSCTA for small aneurysms (Ͻ3.0 mm) were lower than those in our population.…”

Section: Discussionsupporting

confidence: 93%

“…CTA has a high sensitivity and specificity in detecting intracranial aneurysms, 8,9,11,12,17,19,20 but skull base structures can hide adjacent aneurysms. 17,21 Bone-subtraction CTA 22,23 has been developed to overcome this problem.…”

Section: Discussionmentioning

confidence: 99%

“…5,6 Multidetector CT angiography with high spatial resolution and bone-subtraction CTA (BSCTA) approaches the diagnostic accuracy of DSA in the detection of intracranial aneurysms. [7][8][9][10][11][12] Thus, BSCTA can be considered an alternative to DSA in treatment planning. 13,14 Some authors already recommend BSCTA as the primary imaging in acute SAH.…”

mentioning

confidence: 99%

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Diagnostic Impact of Bone-Subtraction CT Angiography for Patients with Acute Subarachnoid Hemorrhage

Aulbach

Mucha

Engellandt

et al. 2015

AJNR Am J Neuroradiol

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Section: Discussionsupporting

confidence: 93%

Section: Discussionmentioning

confidence: 99%

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Diagnostic Impact of Bone-Subtraction CT Angiography for Patients with Acute Subarachnoid Hemorrhage

Aulbach

Mucha

Engellandt

et al. 2015

AJNR Am J Neuroradiol

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“…They also allow the removal of bone and calcium from the carotid and brain CTA (23)(24)(25)(26)(27)(28)(29)(30)(31)(32)(33)(34)(35)(36).…”

Section: Neuroradiological Applicationsmentioning

confidence: 99%

Dual-energy CT revisited by multidetector ct: review of principles and clinical applications

Karçaaltıncaba

Aktaş²

2010

Diagn Interv Radiol

153

127

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A lthough dual-energy CT (DECT) was first conceived in 1976, it has not been used widely for clinical indications (1-11). Recently, the simultaneous acquisition of dual-energy data has been introduced using multidetector CT (MDCT) with two X-ray tubes and rapid peak kilovoltage (kVp) switching (gemstone spectral imaging, GSI) (12-16). Two major advantages of DECT are material decomposition by the almost simultaneous acquisition of two image series with different kVp (80 and 140 kVp) and the elimination of misregistration artifacts. In general, noncontrast (unenhanced) images can be avoided by using the dual-energy mode for body and neurological applications; iodine can be removed from the image, and a virtual non-contrast (water) image can be acquired. The major advantage of 80-kVp compared to 140-kVp images is a higher image contrast (Fig. 1). Hounsfield unit measurements on DECT are not absolute and can change depending on the kVp used for the acquisition (at different keV). Typically, a combination of 80/140 kVp is used for DECT, but for some applications, 100/140 kVp is preferred. In this study, we summarized the clinical applications of DECT in the brain, chest and abdomen and in the cardiovascular and musculoskeletal systems (Table 1). Technique and principlesThe basic principle of dual-energy is the acquisition of 2 datasets from the same anatomic location with different kVp (usually 80 and 140 kVp) (1,2,17,18). In the early days of CT, consecutive single-slice acquisitions with different kVp were performed as a dual-energy technique, but this method suffered from breathing and partial volume artifacts (1, 2). At present, an entire body can be scanned within seconds using the DECT technique, and thus, misregistration artifacts due to breathing are eliminated.Currently, three systems are capable of the nearly simultaneous acquisition of dual-energy data during a single breath hold (12, 14, 15): 64-slice dual-source CT (Definition, Siemens Medical Systems; Erlangen, Germany), 128-slice dual-source CT (Definition Flash, Siemens Medical Systems) and high-definition 64-MDCT (Discovery 750 HD, GE Healthcare; Milwaukee, Wisconsin, USA). In the two systems available from Siemens, the two tubes (tubes A and B) use different kVp (80 and 140 kVp), and in 64-MDCT, the kVp switches from 80 to 140 kVp in less than 0.5 ms. In dual systems, there is concern regarding the susceptibility of the system to cardiac motion due to the time difference (75 or 83 ms) between the tube A and tube B acquisitions of the dual-energy data, but the dual-source CT and 64-MDCT have not been compared to evaluate this issue. The technical specifications of the DECT systems are summarized in Table 2.The images presented in this article were acquired using a 64-slice dual source CT (Definition, Siemens Medical Systems) and a 64-MDCT (Discovery 750HD, GE Healthcare). The DECT data acquired by both systems can be evaluated with a dedicated workstation using dual-energy software that ABSTRACT Although dual-energy CT (DECT) was first conceived in ...

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“…5mm increments with a D30 kernel, for a field of view of 180 mm 2 . The contrast-enhanced CT scan in the dual-energy mode was obtained with a 4.0mL/s injection of 80 ml nonionic contrast medium (Ultravist 300 mg I/ml, Bayer Schering Pharma) followed by 30 ml saline solution into the cubital vein through an 18-gauge catheter after a patient-specific delay determined by a bolus test (28-37s) (15). The images were transferred to a workstation (MultiModality Workplace, Siemens Healthcare), and prototype software (Syngo 2008G, Siemens Healthcare) was used to generate 3D images by volume render (VR) (15).…”

Section: █ Introductionmentioning

confidence: 99%

Skull anatomic landmarks for retrosigmoid craniotomy in a chinese cohort: a 3D-CT study in vivo

Fan

Chen²,

Wang³

et al. 2013

Turkish Neurosurgery

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ABSTRACTas a surgical landmark has been questioned (8). Recent advances in 3D-computed tomography (CT) volume rendering techniques have made it possible to visualize minute bone sutures and venous structures of the posterior fossa (3,5,6,11).The purpose of this study is to determine the anatomic position of the asterion and the transverse-sigmoid sinus junction in Chinese population using the root of the zygoma and the tip of the mastoid process as palpable points. We also tried to clarify the relationship between the asterion and the inferior aspect of the transverse-sigmoid sinus junction using a 3D-CT procedure in vivo (8). █ MATERIAL and METHODSThe Zhejiang University ethics committee approval to fulfill the █ INTRODUCTIONThe correct location of an initial strategic burr hole for a retrosigmoid craniotomy to give access to the cerebellopontine angle (CPA) is paramount in obtaining optimal exposure in this region (12).As the transverse and sigmoid sinuses are the natural limits of these exposures, a knowledge about their cranial topography constitutes the main factor in the planning of these retrosigmoid approaches (10). The asterion serves as the junction of the lambdoid, parietomastoid and occipitomastoid sutures, and has been used in retrosigmoid craniotomy to locate the transverse-sigmoid sinus junction (2, 9, 12-14).As cadaveric studies have shown considerable variability in the relationship of the asterion to the underlying venous structures and its population-specific variability, its validity AIM: This study was designed to determine the anatomic position of the asterion and the relationship between the asterion and the transverse sigmoid sinus junction (TSSJ) in a Chinese cohort. MATERIAL and METHODS:Venous computed tomography (CT) angiography was performed in 32 patients to simultaneously obtain 3D-CT volume rendering images of the cranial bone and the dural sinus. The relationship between the TSSJ and the asterion was analyzed. RESULTS:The distance from the asterion to root of zygoma (ROZ) was 54.6 ± 5.50 mm on the right side and 54.1 ± 5.42 mm on the left side. The asterion was 49.10 ± 3.56 mm above the tip of mastoid process (TOP) on the right side and 48.70 ± 2.23 mm on the left side. The asterion's position was at the junction of the transverse-sigmoid sinus complex in 44 cases, below it in 19 cases, and above it in one case.CONCLUSION: 3D-CT volume rendering imaging is capable of accurately and simultaneously visualizing the bony landmark and the dural sinus structure outline in vivo, thus offering a new option for anatomic research and morphometric investigation. The accurate location of asterion can be found using the root of the zygoma and the tip of the mastoid process.

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Dual-Energy CT Angiography in the Evaluation of Intracranial Aneurysms: Image Quality, Radiation Dose, and Comparison With 3D Rotational Digital Subtraction Angiography

Abstract: On the basis of the findings in the small series of patients evaluated, contrast-enhanced dual-energy CTA had diagnostic image quality at a lower radiation dose than digital subtraction CTA and high diagnostic accuracy compared with 3D DSA in the detection of intracranial aneurysms.

Cited by 101 publications

References 31 publications

Diagnostic Impact of Bone-Subtraction CT Angiography for Patients with Acute Subarachnoid Hemorrhage

Diagnostic Impact of Bone-Subtraction CT Angiography for Patients with Acute Subarachnoid Hemorrhage

Dual-energy CT revisited by multidetector ct: review of principles and clinical applications

Skull anatomic landmarks for retrosigmoid craniotomy in a chinese cohort: a 3D-CT study in vivo

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