Neurological Surgery No Shinkei Geka Volume 25, Issue 12 (December 1997)

Diagnosis of unruptured cerebral aneurysms using magnetic resonance angiography and three-dimensional computed tomographic angiography Tohru OKUYAMA 1 , Koji SAITO 1 , Akira HIRANO 1 , Akira TAKAHASHI 1 , Yuuji HASHIMOTO 1 , Tohru INAGAKI 1 1Department of Neurosurgery, Kushiro Neurosurgical Hospital Keyword: MR angiography , 3D CT angiography , unruptured cerebral aneurysm , diagnosis pp.1073-1079
Published Date 1997/12/10
  • Abstract
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The purpose of this study is to confirm the use of magnetic resonance (MR) angiography and three- dimensional computed tomographic (3D CT) angiogra- phy, in the screening of unruptured cerebral aneurysms.

Sixty-six unruptured cerebral aneurysms in forty-eight patients were examined by MR angiography, 3D CT angiography and digital subtraction angiography (DSA). All cases underwent surgery. Three out of six-ty-six (4.5%) cerebral aneurysms detected by MR angiography and 3D CT angiography were false posi-tive. The false aneurysms were located at the region of the internal carotid artery and the posterior communi-cating artery, and were under 2.0mm in size. The di-agnosis of the infundibular dilatation at the junction of the internal carotid artery and the posterior communi-cating artery remained difficult. The true positive di-agnosis of aneurysms using MR angiography or 3D CT angiography was 95.5%, in our hospital. All unruptured cerebral aneurysms over 2.0mm in size were detected correctly by using MR angiography and 3D CT angiography, as well as DSA. The inadequate diagnosis of aneurysms caused by MR angiography was due to the overlapping of vessels and the surrounding noise. Superselective maximum intensity projection (MIP) and interactive vascular imaging (IVI) were adopted for exact diagnosis. Furthermore, the three slab method of MR angiography was used for containing the limits between the vertebral artery and the distal anterior cerebral artery, and the triple method was able to de-crease surrounding noise. Using MR angiography, we diagnosed and operated on about 100 cases of unrup-tured cerebral aneurysm in one year.

Our conclusion is that we can diagnose any unrup-tured cerebral aneurysm, over 2.0mm in size, using MR angiography and 3D CT angiography.

Copyright © 1997, Igaku-Shoin Ltd. All rights reserved.


Neurological Surgery 脳神経外科
25巻12号 (1997年12月)
電子版ISSN 1882-1251 印刷版ISSN 0301-2603 医学書院