Evaluation of Selective Arterially Enhanced CT and 3-D Reformatting for Pretherapeutical Assessment of Intracranial Aneurysms

Abstract

To evaluate selective arterially enhanced CT angiography (ACT) and 3-D reformatting in the pretherapeutical assessment of intracranial aneurysms. A combined interactive CT and DSA suite deserved by a single pivoting table was used. Reformatted images were obtained using maximum intensity projection, volume rendering and surface shaded display with slicing. Thirty-four patients, 13 male and 21 female, mean age: 50 years (16–73), were explored in a prospective study. Forty-one intracerebral aneurysms were diagnosed. The aneurysmal index was measured on the reformatted images. Radiological findings were compared with surgery. In 31 operative cases, the aneurysmal index and morphological description of the aneurysm as defined by ACT were in agreement with surgical findings. ACT gave specific information in 6 cases which led to a change of the therapeutical approach. ACT facilitated the choice between surgery and endovascular embolization in 19 complex cases (surgery: 12, endovascular embolization:?). ACT improves the pretherapeutical assessment of intracranial aneurysms, particularly in complex cases. Determination of the aneurysmal index is more precise with ACT than with DSA.