Initial exploration of clinical value for diagnosing intracranial aneurysms with multi-slice helical CT three-dimensional angiography

Objective: To evaluate the clinical value of Multi-slice helical CT three dimensional angiography (3D-MSCTA) as first method for diagnosing intracranial aneurysms. Methods: The authors studied patients with clinical suspected intracranial aneurysms (13 patients with subarachnoid hemorrhage among cases). All these patients underwent 3D-MSCTA and Digital Subtraction Angiography (DSA), 16 patients of them accepted operation treatment. Row data was acquired by Multi-slice helical CT-AQUILION (Toshiba): scan speed 0.5 s/rot, image slice thickness 1.0 mm, helical pitch 3.0/5.0. Contrast media (Angiografin) was injected intravenously (1.0-2.0 ml/kg) at speed of 2.5-3.0 ml/s, delay time was 15-23 s, reconstruction interval 0.5 mm, reconstruction slice thickness 1.0 mm. Source images were processed using a workstation SGI-02, images post-processing software was ALATOVIEW, Version 1.21. The reconstructed images were then processed into shaded volume rendering (SVR) and maximal intensity projection (MIP) and Fly-through images. Entire brain DSA was performed obtaining anteroposterior, lateral, and oblique images. Images of 3D-MSCTA and DSA were analysed by 3 radiologists and 2 neurosurgeons. Results: 25 aneurysms were detected by 3D-MSCTA. Aneurysms's body, neck, source vessel and the relationship between the aneurysm and surrounding structures was clearly and surely displayed. 22 of 25 aneurysms were detected by DSA, another 3 were (1 anterior communicating artery aneurysm and 2 left middle cerebral artery aneurysm) was not detected. Sixteen of patients underwent operation treatment, and the results of 3D-MSCTA corresponded very well to those of operation. Maximal diameter of aneurysms body was 14.0 mm and minimal diameter was 1.7 mm. Conclusion: 3D-MSCTA is a high sensitivity and rapid and noninvasive method for detecting intracranial aneurysms. The authors suggest that 3D-MSCTA may be the first choice for diagnosing intracranial aneurysms