Giant cerebral aneurysm: 3D computed tomography angiography vs. rotational 3D digital subtraction angiography

Abstract

The purpose of writing this case study was to compare the accuracy of computed tomography angiography (CTA) and 3D rotational digital subtraction angiography (3D DSA) in demonstrating a giant cerebral aneurysm and its relationship to the parent artery. The patient was a 36-year-old female who presented to our department with a suspected cerebral aneurysm as seen on a non-contrast computerised tomography (CT) brain scan. The CTA and 3D DSA were performed on consecutive days and both demonstrated a giant aneurysm arising from the right posterior cerebral artery. A series of 3D images were produced from both modalities, with each possessing sub-millimeter spatial resolution. After comparison between the two 3D data sets, it was evident that the 3D DSA was superior in delineating the relationship between the aneurysm and its parent artery. The CTA suffered from partial voluming in this area and it seemed as though a connection was present between the aneurysm and posterior cerebral artery distal to the aneurysm neck. Based on the CTA alone, an incorrect report would have resulted. Surgery later confirmed the absence of this connection and, thereby, proved that 3D DSA was more accurate in the visualisation of this patient's aneurysm. Treatment for this patient could therefore be planned more confidently based on the 3D DSA findings.

Flow prediction in cerebral aneurysms based on geometry reconstruction from 3D rotational angiography

“…From medical images, the geometry of brain vessels and aneurysms can be reconstructed only with a certain accuracy [18,22]. We may define a 'basic' geometry on the basis of the segmented raw data.…”

Modeling and simulation of flow in cerebral aneurysms

“…The voxel size varies from one imaging technique to another. Typically reported values are of the order 0.16 mm − 0.535 mm [8,17,24,72,74,84,86]. In addition uncertainty is increased because of slight movement of the patient and external noise influencing the recording of the images.…”

“…In addition uncertainty is increased because of slight movement of the patient and external noise influencing the recording of the images. A comparison study between CTA and DSA techniques is presented in [72], where DSA is found to be more accurate than CTA for reproducing the shape of a comparably large aneurysm and its relationship to the parent artery. In [95] it is shown that detection of much smaller aneurysms (even with a diameter less than 3 mm) is best performed on the basis of 3DRA.…”

“…From medical images the geometry of brain vessels and aneurysms can be reconstructed only with a certain accuracy [72,95]. We may define a 'basic' geometry on the basis of the segmented raw data.…”