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Multidetector-Row CT Angiography of Cerebral Vasospasm after Aneurysmal Subarachnoid Hemorrhage: Comparison of Volume-Rendered Images and Digital Subtraction Angiography

D.Y. Yoona, C.S. Choia, K.H. Kima and B.-M. Chob

a Department of Radiology, Hallym University College of Medicine, Seoul, Korea
b Department of Neurosurgery, Hallym University College of Medicine, Seoul, Korea


Figure 1
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  		Fig 1. Case 6, a 73-year-old woman with SAH.

A, Preoperative MDCTA image, superior view, shows an anterior communicating artery aneurysm (long arrow). Left posterior communicating artery aneurysm was well visualized on other projections of MDCTA images (not shown). Note the multiple focal stenoses in the left M1 segment (arrows).

B, Postoperative MDCTA image, obtained 7 days after surgery, shows clipping of the aneurysms and multiple spasms of bilateral A1 and A2 segments. Note total occlusion of right A1 segment, as well as no change of stenoses in the left M1 segment consistent with preexisting atherosclerotic stenoses.

C and D, Postoperative right (C) and left (D) carotid angiograms, anteroposterior view, confirm vasospasm involving bilateral anterior cerebral arteries. Note grade 3 spasm (50%–99% luminal narrowing) in the right A1 segment, which was overestimated as grade 4 spasm (total occlusion) on MDCTA (B).


Figure 2
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  		Fig 2. Case 5, a 42-year-old man with SAH.

A, Preoperative MDCTA image, superior view, shows an anterior communicating artery aneurysm (arrow).

B, Postoperative MDCTA image, obtained 5 days after surgery, shows clipping of the aneurysms and multiple spasms of bilateral A1, A2, left M1, and M2 segments.

C, The small remnant aneurysm (arrow) after aneurysm clipping is depicted on the anteroposterior MDCTA image with automated segmentation.

D and E, Postoperative right (D) and left (E) carotid angiograms, anteroposterior view, confirm vasospasm involving bilateral anterior cerebral and left middle cerebral arteries. The small remnant aneurysm (arrow) is also noted.





Copyright © 2008 by the American Society of Neuroradiology. Print ISSN: 0195-6108 Online ISSN: 1936-959X