Diagnostic Accuracy of CT Angiography with Matched Mask Bone Elimination for Detection of Intracranial Aneurysms: Comparison with Digital Subtraction Angiography and 3D Rotational Angiography

Romijn, M. G.; Andel, H.A.F. Gratama van; Walderveen, Marianne AA van; Sprengers, Marieke E.S.; Rijn, Jeroen C. van; Rooij, W.J. van; Venema, Henk W.; Grimbergen, C.A.; Heeten, Gerard J. den; Majoie, Charles B. L. M.

doi:10.3174/ajnr.a0741

Cited by 111 publications

(53 citation statements)

References 34 publications

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“…31,32 Interobserver agreement in our study was somewhat higher than that reported previously. 11,17,19,26 Intraobserver agreement was excellent as in another study by Lu et al 11 We had excellent interreader agreement for aneurysm identification and configuration. Our results are in line with those in other studies, 17,26 even with a recent study with 320 -detector row BSCTA 33 comparing CTA with intraoperative observations.…”

Section: Discussionsupporting

confidence: 50%

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Diagnostic Impact of Bone-Subtraction CT Angiography for Patients with Acute Subarachnoid Hemorrhage

Aulbach

Mucha

Engellandt

et al. 2015

AJNR Am J Neuroradiol

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Section: Discussionsupporting

confidence: 50%

“…CTA has a high sensitivity and specificity in detecting intracranial aneurysms, 8,9,11,12,17,19,20 but skull base structures can hide adjacent aneurysms. 17,21 Bone-subtraction CTA 22,23 has been developed to overcome this problem.…”

Section: Discussionmentioning

confidence: 99%

Diagnostic Impact of Bone-Subtraction CT Angiography for Patients with Acute Subarachnoid Hemorrhage

Aulbach

Mucha

Engellandt

et al. 2015

AJNR Am J Neuroradiol

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“…In an article published in 2007 by Ishihara et al, this was studied and confirmed in a small collective of 15 patients [10]. Other studies evaluate different advantages of 3 D DSA, e. g. the number of detected aneurysms [11], and the advantages of 3 D DSA for treatment planning [12] and for treatment success monitoring [13]. We also use 3 D DSA for diagnostic verification of bleeding source as well as for intervention/ operation planning.…”

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confidence: 72%

3D Rotational Angiography After Non-Traumatic SAH

Ringelstein

Mueller

Mönninghoff

et al. 2014

Fortschr Röntgenstr

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!Purpose: In about 15 % of patients with SAH no causative vascular lesions can be found in acute imaging with CTA and DSA. Usually, repeat DSA is mandatory and bears the usual risk of invasive angiography. The present study attempts to assess the diagnostic impact of 3 D rotational angiography in order to avoid repeat DSA. Results: In the second DSA scan, 4 aneurysms in 4 patients (4/91; 4.4 %) were found and treated subsequently. Within the first 4.5 years of this study, 401 patients with SAH were treated and 61 of them underwent repeat angiography (15.2 %) compared to 30 of 248 patients (12.1 %) in the last 4.5 years of this study. In the first group we found 3 aneurysms during repeat angiography, and in the second group we found 1. No significance was reached (p = 0.29) but there was a tendency towards higher diagnostic security using 3D-DSA. Conclusion: Using 3 D rotational DSA in initial imaging workup might help to reduce falsenegative results concerning the bleeding source of acute SAH. At least because of this fact, 3 D rotational DSA should be part of the diagnostic workup after acute SAH. Key Points:▶ In 15 % of SAH patients no causative vascular lesion can be found using conventional DSA compared to 12 % using 3 D DSA.

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“…Manual bone editing in CTA is a time-consuming and user-dependent process that relies on a knowledge of vascular anatomy (13,14). Matched mask bone elimination (MMBE) is a relatively new technique that enables bone removal in an automatic and user-independent way (18,22). In CTA-MMBE, a second, non-enhanced scan is necessary for the identification of bony structures that could be masked in the CTA scan.…”

Section: Per-patientmentioning

confidence: 99%

Subtraction CT angiography for the detection of intracranial aneurysms: A meta-analysis

Feng

Han

Lang

et al. 2016

Experimental and Therapeutic Medicine

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Abstract. The aim of this meta-analysis was to investigate the accuracy of subtraction computed tomography angiography (CTA) for diagnosing intracranial aneurysms. A systematic literature search up to January 1, 2013 was performed in PubMed. Two independent reviewers selected 8 studies that compared subtraction CTA with digital subtraction angiography. Data from the studies were used to construct a 2x2 contingency table on a per-patient basis in ≥5 diseased and 5 non-diseased patients, with additional data on a per-aneurysm basis. Overall, subtraction CTA had a pooled sensitivity of 99% [95% confidence interval (CI), 95-100%] and specificity of 94% (95% CI, 86-97%) for detecting and ruling out cerebral aneurysms, respectively, on a per-patient basis. On a per-aneurysm basis, the pooled sensitivity was 96% (95% CI, 90-99%), and the specificity was 91% (95% CI, 85-95%).In conclusion, subtraction CTA is a highly sensitive, specific and non-inva sive method for the diagnosis and evaluation of intracranial aneurysms. IntroductionThe prevalence of cerebral aneurysm in the general population is estimated to be 1-5% (1). Ruptured intracranial aneurysms are the most important cause of non-traumatic subarachnoid hemorrhage, which is a medical emergency and can result in severe disability or mortality (2). Thus, the prompt diagnosis and treatment of intracranial aneurysm are of considerable importance for the outcome of the patient.Conventional digital subtraction angiography (DSA) has been considered the gold standard for the detection and characterization of intracranial aneurysms due to its high spatial resolution and large field of view (3,4); however, it also has several disadvantages, including the relatively high cost and the high skill level required to perform the procedure. Furthermore, DSA is an invasive procedure associated with a small but definite risk of neurological morbidity (5). There is a requirement, therefore, to find an accurate, minimally invasive imaging method that is free from these complications. Computed tomography angiography (CTA), as a relatively non-invasive imaging method, has been widely used in the screening of patients with suspected intracranial aneurysms (6). As a result of the rapid improvement in multi-detector CTA technology, the diagnostic performance of multi-detector CTA for the detection of intracranial aneurysms is now approaching that of DSA (7); however, it exhibits a disadvantage in the detection of small-sized aneurysms that are located near the skull base due to the influence of overprojecting bone structures (8).As CT technology has evolved and various subtraction and post-processing techniques have been developed, subtraction CTA, allowing bone-free visualization of aneurysms, has become possible for the diagnosis of intracranial aneurysms. There have been several reports on the potential usefulness of subtraction CTA in evaluating intracranial aneurysms; however, the results of these studies have been varied (6-8). The purpose of this meta-analysis was to calculate the ...

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Diagnostic Accuracy of CT Angiography with Matched Mask Bone Elimination for Detection of Intracranial Aneurysms: Comparison with Digital Subtraction Angiography and 3D Rotational Angiography

Abstract: BACKGROUND AND PURPOSE: Our aim was to determine the diagnostic accuracy of multisection CT angiography combined with matched mask bone elimination (CTA-MMBE) for detection of intracranial aneurysms compared with digital subtraction angiography (DSA) and 3D rotational angiography (3DRA).

Cited by 111 publications

References 34 publications

Diagnostic Impact of Bone-Subtraction CT Angiography for Patients with Acute Subarachnoid Hemorrhage

Diagnostic Impact of Bone-Subtraction CT Angiography for Patients with Acute Subarachnoid Hemorrhage

3D Rotational Angiography After Non-Traumatic SAH

Subtraction CT angiography for the detection of intracranial aneurysms: A meta-analysis

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