Detection and Characterization of Intracranial Aneurysms with 16-Channel Multidetector Row CT Angiography: A Prospective Comparison of Volume-Rendered Images and Digital Subtraction Angiography
D.Y. Yoona,
K.J. Lima,
C.S. Choia,
B.M. Chob,
S.M. Ohb and
S.K. Changa
a Department of Radiology, Hallym University College of Medicine, Seoul, South Korea
b Department of Neurosurgery, Hallym University College of Medicine, Seoul, South Korea
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Fig 1. A 72-year-old woman with subarachnoid hemorrhage.
A and B, Volume-rendered MDCTA images obtained with right anterior oblique (A) and lateral (B) projections demonstrate a bilobed aneurysm at the bifurcation of the right internal carotid artery (arrow). There are also 2 small aneurysms at the posterior communicating artery (long arrow) and the anterior choroidal artery (arrowhead). The anterior choroidal artery aneurysm was missed by reader 2 at initial interpretation.
C, The same aneurysms (arrows and an arrowhead) are also depicted on the lateral projection DSA image of the right internal carotid artery.
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Fig 2. A 71-year-old woman with subarachnoid hemorrhage.
A, Left anterior oblique projection volume-rendered MDCTA image shows a saccular aneurysm arising from the anterior communicating artery (arrow). The neck of aneurysm was graded as wide (grade 3; N/D ratio, >2/3) by both readers on the basis of volume-rendered images.
B, DSA image of the left internal carotid artery, obtained in a projection similar to that of the DSA image shown in A, shows the narrow (grade 1; N/D ratio, <1/3) neck of the aneurysm (arrow).
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Fig 3. A 57-year-old man with subarachnoid hemorrhage.
A, Superior projection volume-rendered MDCTA image shows a small aneurysm of the anterior communicating artery (arrow). With this technique, the neck of the aneurysm is obscured by both overlying anterior cerebral arteries despite multiple projections (not shown).
B, Anteroposterior projection volume-rendered MDCTA image with automated segmentation shows laterally and inferiorly directed saccular aneurysm at the anterior communicating artery (arrow). The relations of the aneurysmal neck can be demonstrated better with this postprocessing software.
C, Corresponding DSA image of the left internal carotid artery shows the same aneurysm (arrow).
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