The value of dual-energy CTA for control of surgically clipped aneurysms

Fahrendorf, Delia M.; Goericke, Sophia L.; Oezkan, Neriman; Breyer, Thiemo; Hussain, S.I.; Sandalcioglu, Erol I.; Sure, Ulrich; Forsting, Michael; Gizewski, Elke R.

doi:10.1007/s00330-011-2147-x

Cited by 15 publications

(7 citation statements)

References 21 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…A study investigating the potential value of DE-CTA imaging for surgically treated IAs using a 64-row dual-source CT scanner system reported significantly lower artifacts and/or superior visualization of the clipped IAs and branching arteries based on subjective image evaluation [35]. In contrast to this study, we investigated and found objective imaging superiority of DE-CTA over SE-CTA by quantifying the artifact volume.…”

Section: Discussioncontrasting

confidence: 42%

“…Thus, our data are in accordance with those reported by Dolati et al [36] supporting the reported accuracy of DE-CTA to detect IA remnants of <2 mm and parent vessel patency in clipped IAs. Both Fahrendorf et al [35] and Dolati et al [36] did not report on the value of DE-CTA after endovascular treatment of IAs, and even though beam-hardening artifact volumes were significantly reduced by DE-CTA in our study, the overall image quality of DE-CTA for evaluation of IAs and parent arteries after endovascular repair seems to have no benefit over MRA as a noninvasive follow-up image modality. Recent data on a novel MRA algorithm that contains an ultrashort echo time combined with an arterial spin-labeling technique (silent MRA) have demonstrated the value of MRA as an alternative to catheter angiography, not only for evaluating IA occlusion rate but also for visualization of flow in intracranial stents after stent-assisted coil embolization [37].…”

Section: Discussioncontrasting

confidence: 39%

See 1 more Smart Citation

Dual- versus Single-Energy CT-Angiography Imaging for Patients Undergoing Intracranial Aneurysm Repair

Abdulazim¹,

Rubbert²,

Reichelt³

et al. 2017

Cerebrovasc Dis

View full text Add to dashboard Cite

Background: The invasiveness and risk of thromboembolic complications of catheter angiography underline the need for alternative imaging modalities in patients following intracranial aneurysm (IA) repair. However, the overall image quality of existing noninvasive imaging modalities, such as single-energy CT angiography (SE-CTA), compromises its value in this respect. Objective: We prospectively investigated the value of a novel dual-energy CTA (DE-CTA) scanner and algorithm for assessing the degree of occlusion and parent vessel patency in patients following IA repair. Methods: A prospective cohort of 17 patients underwent DE-CTA imaging following surgical or endovascular IA repair. This dataset was matched with an identical historical cohort of 17 patients, who underwent IA repair and SE-CTA imaging. Beam-hardening artifacts, as a measure for objective imaging quality were analyzed based on the volume of a prolate ellipsoid, whereas subjective imaging quality at the IA site and corresponding parent vessels was rated by 2 independent neuroradiologists on a scale from 4 (excellent, no artifacts) to 1 (poor, severe artifacts). Results: Objective DE-CTA image quality was markedly higher, compared to SE-CTA in patients undergoing surgical (0.77 ± 0.23 vs. 10.91 ± 1.88 mL, respectively; p < 0.001) or endovascular (32.36 ± 10.62 vs. 107.63 ± 24.51 mL, respectively; p = 0.026) IA repair. Subjective image quality for DE-CTA was significantly improved compared to SE-CTA in the surgical group but not in the endovascular group. The calculated dose values for DE-CTA in our study remain markedly below the legally required radiation dose limits. Conclusion: The imaging quality of DE-CTA, especially for patients undergoing surgical IA repair, is distinctly superior, compared to SE-CTA imaging. Therefore, DE-CTA may serve as a noninvasive alternative for assessing the IA occlusion rate and parent vessel patency.

show abstract

Section: Discussioncontrasting

confidence: 42%

Section: Discussioncontrasting

confidence: 39%

Dual- versus Single-Energy CT-Angiography Imaging for Patients Undergoing Intracranial Aneurysm Repair

Abdulazim¹,

Rubbert²,

Reichelt³

et al. 2017

Cerebrovasc Dis

View full text Add to dashboard Cite

show abstract

“…Overall, the risk of (re-) rupture in these cases remains unclear for now. Thus, significant consequences for patients may be repetitive control MRI/dual source energy CT [7] or invasive angiography with potential side effects or even a re-treatment of the lesion. Besides the risk of repair, these data have to be balanced against the natural history of unruptured MCA aneurysms as well.…”

Section: Occlusion Ratesmentioning

confidence: 99%

Outcome for unruptured middle cerebral artery aneurysm treatment: surgical and endovascular approach in a single center

et al. 2014

Self Cite

View full text Add to dashboard Cite

The rupture of an intracranial aneurysm leads to subarachnoid hemorrhage (SAH). To prevent SAH, unruptured lesions can be treated by either endovascular or microsurgical approach. Due to their complex anatomy, middle cerebral artery (MCA) aneurysms represent a unique subgroup of intracranial aneurysms. Primary objective was to determine radiological and clinical outcomes in patients with middle cerebral artery aneurysms who were interdisciplinary treated by either endovascular or microsurgical approach in a single center. Secondary objective was to determine the impact of the lesions' angiographic characteristics on treatment outcome. Clinical and radiological data of 103 patients interdisciplinary treated for unruptured MCA aneurysms over a 5-year period were analyzed in endovascular (n = 16) and microsurgical (n = 87) cohorts. Overall morbidity (Glasgow Outcome Score <5) after 12-month follow-up was 9 %. There was no significant difference between the two cohorts. Complete or "near complete" aneurysm occlusion was achieved in 97 and 75 % in the microsurgical, respective endovascular cohort. A "complex" aneurysm configuration had a significant impact on complete aneurysm occlusion in both cohorts, however, not on clinical outcome. Treatment of unruptured MCA aneurysms can be performed with a low risk of repair using both approaches. However, the risk for incomplete occlusion was higher for the endovascular approach in this series.

show abstract

“…Diese sind aber bisher noch nicht in die Routinediagnostik integriert [24]. Die Beurteilung clipversorgter Aneurysmen ist mit der zunehmend verfügbaren Dual Energy-CT-Technik schon sehr gut möglich [25]. Mit der geeigneten technischen Ausstattung, insbesondere mit geeigneten Rekonstruktionsalgorithmen, ist die CTA der 3D-DSA heute sowohl in der Detektion von Aneurysmen als auch zur Therapieindikationsstellung und zur Therapieplanung ebenbürtig.…”

Section: Die Rolle Der Computertomografieunclassified

Sensitivität und Spezifität bildgebender Verfahren für den Nachweis intrakranieller Aneurysmen

Ringelstein

Forsting

2014

Akt Neurol

View full text Add to dashboard Cite

Zusammenfassung Aneurysmen der intrakraniellen Arterien treten mit einer Pr?valenz von etwa 2?% auf. Die Rupturwahrscheinlichkeit beerenf?rmiger Aneurysmen liegt bei etwa 0,1?%/Jahr. Die Letalit?t innerhalb von 30 Tagen nach der Ruptur eines zerebralen Aneurysmas wird auf 45?% gesch?tzt; zus?tzlich beh?lt die H?lfte der ?berlebenden Patienten schwere neurologische Defizite. Der rechtszeitige Nachweis und die prophylaktische Therapie eines Aneurysmas ist die zuverl?ssigste Methode, eine Ruptur zu vermeiden. Insofern ist es relevant, das Potenzial der aktuellen bildgebenden Verfahren zu kennen, anwenden zu k?nnen und an Verbesserungen der verschiedenen Verfahren teilzunehmen. Diese Arbeit stellt das diagnostische Potenzial der CT, MRT und Katheterangiografie zur Detektion, Therapieplanung und Nachsorge von Aneurysmen dar und leitet daraus eine Handlungsempfehlung ab.

show abstract

The value of dual-energy CTA for control of surgically clipped aneurysms

Cited by 15 publications

References 21 publications

Dual- versus Single-Energy CT-Angiography Imaging for Patients Undergoing Intracranial Aneurysm Repair

Dual- versus Single-Energy CT-Angiography Imaging for Patients Undergoing Intracranial Aneurysm Repair

Outcome for unruptured middle cerebral artery aneurysm treatment: surgical and endovascular approach in a single center

Sensitivität und Spezifität bildgebender Verfahren für den Nachweis intrakranieller Aneurysmen

Contact Info

Product

Resources

About