Original investigationComparison of Standard- and Low-Tube Voltage 320-Detector Row Volume CT Angiography in Detection of Intracranial Aneurysms with Digital Subtraction Angiography as Gold Standard
Section snippets
Patients
Between January 2009 and August 2010, a total of 48 patients were enrolled in this prospective study. The inclusion criterion was an indication for CTA and DSA because of acute suspicion of a ruptured intracranial aneurysm. This prospective study was approved by the institutional ethics review board. Informed consent was obtained from all participating patients.
The patients were randomly assigned to undergo L-VCTA (n = 24) or C-VCTA (n = 24), using a computer-generated list to ensure
Image Quality
In the quantitative ROI analysis of Hounsfield units (HU), absolute values tended to be higher for the L-VCTA group than for the C-VCTA group. The mean attenuation and noise values are shown in Table 1. The average differences in mean attenuation were 125.5 HU in the largest vessel, 99.92 HU in the second segment of the middle cerebral artery, and 129.49 HU in the basilar artery trunk (P < .001). These data indicated a 42% to 58% increase in arterial attenuation at 80 kVp compared to arterial
Discussion
In the acute setting of suspected intracranial aneurysmal subarachnoid hemorrhage, therapeutic decision making requires rapid and accurate assessment of the presence of an aneurysm. Although DSA has remained the gold standard for the detection of intracranial aneurysms, it has several disadvantages: it is invasive and time consuming, it requires highly experienced operators, and it carries procedural risks such as cerebral ischemia with persistent neurologic deficits 17, 18. The advances in
References (29)
- et al.
Detection of intracranial aneurysms with 64 channel multidetector row CT: comparison with DSA
Eur J Radiol
(2007) - et al.
4-D imaging in cerebrovascular disorders by using 320-slice CT: feasibility and preliminary clinical experience
Acad Radiol
(2009) - et al.
Time trends in outcome of subarachnoid hemorrhage: population-based study and systematic review
Neurology
(2010) - et al.
Declining mortality from subarachnoid hemorrhage: changes in incidence and case fatality from 1985 through 2000
Stroke
(2004) - et al.
Intracranial aneurysms: clinical value of 3D digital subtraction angiography in the therapeutic decision and endovascular treatment
Radiology
(2001) - et al.
Detection of intracranial aneurysms: multi-detector row CT angiography compared with DSA
Radiology
(2004) - et al.
Dual-energy direct bone removal CT angiography for evaluation of intracranial aneurysm or stenosis: comparison with conventional digital subtraction angiography
Eur Radiol
(2009) - et al.
Risk of cerebral angiography in patients with subarachnoid hemorrhage, cerebral aneurysms, and arteriovenous malformations: a meta-analysis
Stroke
(1999) - et al.
Dual-energy CT angiography in the evaluation of intracranial aneurysms: image quality, radiation dose, and comparison with 3D rotational DSA
AJR Am J Roentgenol
(2010) - et al.
320-slice CT neuroimaging: initial clinical experience and image quality evaluation
Br J Radiol
(2009)
Effect of low doses of ionizing radiation in infancy on cognitive function in adulthood: Swedish population based cohort study
BMJ
Dose exposure of patients undergoing comprehensive stroke imaging by multidetector-row CT: comparison of 320-detector row and 64-detector row CT scanners
AJNR Am J Neuroradiol
Dynamic CT angiography and CT perfusion employing a 320-detector row CT
Clin Neuroradiol
Multi-detector row CT angiography of the brain at various kilovoltage settings
Radiology
Cited by (25)
Temporal averaging angiographic reconstructions from whole-brain CT perfusion for the detection of vasospasm
2023, Journal of NeuroradiologyDiagnosis and Treatment of Intracranial Aneurysms with 320-Detector Row Volumetric Computed Tomography Angiography
2016, World NeurosurgeryCitation Excerpt :Recent clinical innovations include a 320-detector row computed tomography (CT) featuring a 16-cm-wide scanner.3 The scanner enables full brain coverage in a single gantry rotation, enabling the acquisition of combined volumetric angiographic data after the injection of a single contrast material.13,14 Because subtracted 320-detector row volume-computed tomography angiography (VCTA) has been shown to be comparable with DSA for the detection of intracranial aneurysms,15 the present study was designed to evaluate the diagnostic accuracy of the 320-detector row VCTA for intracranial aneurysms and determine its clinical utility.
320-Detector row CT angiography for detection and evaluation of intracranial aneurysms: Comparison with conventional digital subtraction angiography
2013, Clinical RadiologyCitation Excerpt :Moreover, Sun et al.14 assessed the effect of low-tube voltage (80 kVp) 320-detector row volume CTA (L-VCTA) in the detection of intracranial aneurysms and found that the sensitivity in the L-VCTA (94.12%) was in inferior to the conventional tube voltage (120 kVp) volume CTA (C-VCTA) groups (100%). However, L-VCTA was superior to C-VCTA in objective image quality and at a lower radiation dose.14 Initial studies with single-detector CTA reported sensitivities between 62 and 100%, and specificities between 98 and 100% for the detection of intracranial aneurysms.15,16