Three-dimensional volume rendering digital subtraction angiography in comparison with two-dimensional digital subtraction angiography and rotational angiography for detecting aneurysms and their morphological properties in patients with subarachnoid hemorrhage

Küçükay, Fahrettin; Ökten, Rıza Sarper; Tekiner, Ayhan; Dağlı, Mustafa; Gocek, Cevdet; Bayar, Mehmet Akif; Cumhur, Turhan

doi:10.1016/j.ejrad.2011.10.006

Cited by 28 publications

(21 citation statements)

References 14 publications

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“…Our observation suggests that 3D angiography is more sensitive to, and thus more suitable for the detection of, these small aneu rysms than conventional angiography. 20 Considering the literature and our own observations, it is also probable that the incidence of LSA aneurysms is underestimated.…”

Section: Discussionmentioning

confidence: 99%

Rupture of lenticulostriate artery aneurysms

Heck¹,

Anxionnat

Lacour

et al. 2014

JNS

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The authors report on 3 rare cases of ruptured lenticulostriate artery (LSA) aneurysms that were heralded by deep cerebral hematomas. The hematomas were unilateral in 2 cases and bilateral in 1; in the bilateral case, only a single LSA aneurysm could be identified on the right side of the brain. Because of their small size (≤ 2 mm), fusiform aspect, and deep location within the brain, all of the aneurysms were treated conservatively. There was no hemorrhage recurrence, and followup angiography demonstrated spontaneous thrombosis in 2 of the 3 cases. The clinical course was favorable in 2 of the 3 patients. The course in the patient with the bilateral hematoma was marked by an ischemic event after the initial episode, resulting in an aggravation of deficits. The cause of this second event was uncertain.Because our knowledge about the natural history of LSA aneurysms is incomplete, there is no consensus con cerning a therapeutic strategy. The authors' experience in 3 reported cases leads them to think that a conservative ap proach involving close angiographic monitoring may be proposed as first-line treatment. If the monitored aneurysm then persists or grows in size, its occlusion should be considered. Nonetheless, other studies are needed to further strengthen the legitimacy of this strategy. (http://thejns.org/doi/abs/10.3171/2013.8.JNS13608) key WOrDs • lenticulostriate artery • aneurysm • cerebral hemorrhage • intracerebral hematoma • stroke • vascular disorders Abbreviations used in this paper: AVM = arteriovenous malfor mation; CTA = CT angiography; IVH = intraventricular hemor rhage; LSA = lenticulostriate artery; MRA = MR angiography; mRS = modified Rankin Scale; SAH = subarachnoid hemorrhage.

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Section: Discussionmentioning

confidence: 99%

Rupture of lenticulostriate artery aneurysms

Heck¹,

Anxionnat

Lacour

et al. 2014

JNS

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“…[135][136][137][138] In addition, the resolution provided by DSA is greater for the smallest of vessels, such as perforators. [139][140][141][142][143][144] Although DSA remains the gold standard, it should be recognized that catheter arteriography does have risks, albeit small. Possible complications include contrast-related events, cerebral infarction, aneurysmal rupture, arterial injury, and others.…”

Section: -134mentioning

confidence: 99%

Guidelines for the Management of Patients With Unruptured Intracranial Aneurysms

Thompson¹,

Brown²,

Amin‐Hanjani³

et al. 2015

Stroke

799

352

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Purpose— The aim of this updated statement is to provide comprehensive and evidence-based recommendations for management of patients with unruptured intracranial aneurysms. Methods— Writing group members used systematic literature reviews from January 1977 up to June 2014. They also reviewed contemporary published evidence-based guidelines, personal files, and published expert opinion to summarize existing evidence, indicate gaps in current knowledge, and when appropriate, formulated recommendations using standard American Heart Association criteria. The guideline underwent extensive peer review, including review by the Stroke Council Leadership and Stroke Scientific Statement Oversight Committees, before consideration and approval by the American Heart Association Science Advisory and Coordinating Committee. Results— Evidence-based guidelines are presented for the care of patients presenting with unruptured intracranial aneurysms. The guidelines address presentation, natural history, epidemiology, risk factors, screening, diagnosis, imaging and outcomes from surgical and endovascular treatment.

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“…Volume rendering (VR) is a technique commonly used for the reconstruction of 3D DSA images [3][4][5][6][7][8][9][10], and the rendering parameters greatly affect the characteristics of the 3D image [11,12]. To our knowledge, no study has identified the optimal rendering parameters for 3D DSA images.…”

Section: Introductionmentioning

confidence: 95%

“…2 Rotational 2D DSA images in which the mean diameter was calculated as a true value by syngo AX vessel analysis software at thresholds of 4500 (a), 2500 (b), and 500 (c) Fig. 3 In the region of the 620×620 area at the center of the rotational 2D DSA image (a), the contrast-enhanced area was extracted (b) [5][6][7][8][9][10]. These injection parameters are considered not optimal and seem to be excessive in order to ensure examination success.…”

Section: Discussionmentioning

confidence: 99%

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Relationship Between the Contrast Effects of Raw Data Projection Images from Three-Dimensional Digital Subtraction Angiography and the Optimal Volume Rendering Parameters

2014

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Volume rendering (VR) is a technique commonly used for the reconstruction of three-dimensional (3D) digital subtraction angiography (DSA) images, and the rendering parameters greatly affect the characteristics of the 3D image. This study aimed to test whether the optimal VR parameters for 3D DSA could be estimated from the contrast effects in rotational two-dimensional (2D) DSA images acquired using 3D DSA. Simulated blood vessels filled with various concentrations of contrast medium were scanned, and the 3D DSA data sets were reconstructed. The syngo AX vessel analysis software that was able to analyze 3D DSAVR image was used for objective measures. Raw data projection images of the 3D DSA data sets in which the mean diameter was calculated as a true value by the software at nine different thresholds for vessel segmentation were selected. In each image set, five images of all 133 rotational 2D DSA images were selected, and the contrast-enhanced area was extracted using a regiongrowing algorithm. Mean values and standard deviations of each contrast-enhanced area were calculated, and as the thresholds for vessel segmentation of the software increased by 500 every time, significant differences were observed in the mean values (P<0.01). This optimal threshold can be applied to the window settings of the VR technique. Therefore, the optimal VR parameters for 3D DSA may be determined by analyzing the contrast effects of the raw data projection images, and user-dependent over-and underestimations of 3D DSA VR images also may be prevented.

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Three-dimensional volume rendering digital subtraction angiography in comparison with two-dimensional digital subtraction angiography and rotational angiography for detecting aneurysms and their morphological properties in patients with subarachnoid hemorrhage

Cited by 28 publications

References 14 publications

Rupture of lenticulostriate artery aneurysms

Rupture of lenticulostriate artery aneurysms

Guidelines for the Management of Patients With Unruptured Intracranial Aneurysms

Relationship Between the Contrast Effects of Raw Data Projection Images from Three-Dimensional Digital Subtraction Angiography and the Optimal Volume Rendering Parameters

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