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

Abstract

BACKGROUND AND PURPOSE: Detection and evaluation of ruptured aneurysms is critical for choosing an appropriate endovascular or neurosurgical intervention. Our aim was to assess whether bone-subtraction CTA is capable of guiding treatment for cerebral aneurysms in patients with acute SAH and could replace DSA.

Comparison of eye-lens doses imparted during interventional and non-interventional neuroimaging techniques for assessment of intracranial aneurysms

“…In our study image quality for the depiction of aneurysms >3 mm was evaluated as good for both imaging techniques. These results are in line with recent studies, which highlight the potential of CT diagnosis compared with interventional angiography 11. Therefore, in future for diagnosis of intracranial aneurysms >3 mm we recommend CTA as the preferred imaging method at the lowest eye-lens dose level.…”

“…Image quality was evaluated on the basis of examinations of patients with an incidental aneurysm finding (size >3 mm). For smaller aneurysms (<3 mm) diagnostic confidence about the presence of an aneurysm may be greater with interventional angiography 11. Therefore, the depiction of aneurysms ≤3 mm may still require diagnostic DSA, resulting in an increase in eye-lens dose, particularly in cases of subarachnoid hemorrhage.…”

“…However, previous studies focused primarily on cost-effectiveness, diagnostic accuracy, and procedural complications; few studies discussed radiation doses 10. Recent studies indicate that bone-subtraction CTA may be as accurate as DSA in detecting cerebral aneurysms after subarachnoid hemorrhage at a lower radiation dose 11. Comparison of CTA and interventional angiography, including 3D-rotational angiography, for their eye-lens dose has not yet been discussed.…”

Metallic Component Preserving Algorithm Based on the Cerebral Computed Tomography Angiography in Aneurysm Surgery

“…NS-CTA is performed using the multidetector-row CT when injecting the contrast agent, whereas BS-CTA requires twice CT scan with and without the injection of contrast medium under the same conditions. It is accurate in detecting cerebral aneurysms and in guiding rapid treatment decisions compared with NS-CTA [ 9 ]. The concept of BS-CTA technique is illustrated in Figure 1 .…”

Subtraction CT angiography in head and neck with low radiation and contrast dose dual-energy spectral CT using rapid kV-switching technique

“…Subtraction CT angiography (sCTA) in the head and neck has therefore emerged recent years to improve the separation between blood vessels and bones and has shown good results. [3][4][5][6][7] In a typical sCTA, iodine doses of 21-27g are commonly used to ensure sufficient opacity in the vessels and good image quality. [6][7][8]…”