DOI QR코드

DOI QR Code

Evaluation of the Accuracy in Maximum Intensity Projection Images of Cerebral Computed Tomographic Angiography for the Diagnosis of Cerebral Vasospasm Following Subarachnoid Hemorrhage, in Comparison to Digital Subtraction Angiography

  • Kim, Jong-Hoon (Department of Neurosurgery, Yeungnam University Medical Center) ;
  • Yi, Ji-Hyun (Department of Radiology, Yeungnam University Medical Center) ;
  • Chang, Chul-Hoon (Department of Neurosurgery, Yeungnam University Medical Center) ;
  • Jung, Young-Jin (Department of Neurosurgery, Yeungnam University Medical Center)
  • Received : 2017.03.30
  • Accepted : 2018.03.11
  • Published : 2018.03.31

Abstract

Objective : The purpose of this retrospective study is to determine the accuracy of maximum intensity projection (MIP) images of computed tomographic angiography (CTA) for diagnosis of cerebral vasospasm (CV) following subarachnoid hemorrhage (SAH) compared with that of digital subtraction angiography (DSA). Materials and Methods : For patients admitted to our hospital for SAH, MIP images of CTA and DSA were checked at admission, and images were taken again 1 week later. This protocol was used in 39 cases. MIP images of CTA and DSA examinations were reviewed by two independent readers. Results : Accuracy of MIP images of CTA in various arterial segments, using DSA as the gold standard: the sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy for different segments varied from 84 to 97, 33-100, 84-100%, 25-85, and 79-97%, respectively, for readers. Accuracy of CTA in various vasospasm severity, using DSA as the gold standard: the sensitivity, specificity, PPV, NPV, and accuracy for different vasospasm severity varied from 44 to 100, 69-100, 36-100%, 61-100, and 88-100%, respectively, for readers. Accuracy of CTA in central segments versus peripheral segments, using DSA as the gold standard: the sensitivity, specificity, PPV, NPV, and accuracy for central segments and peripheral segments varied from 90 to 94, 68-83, 93-97%, 56-69, and 87-93%, respectively, for readers. Conclusion : MIP imaging of CTA is a useful modality when diagnosing CV after SAH.

Keywords

References

  1. Anderson GB, Ashforth R, Steinke DE, Findlay JM. CT angiography for the detection of cerebral vasospasm in patients with acute subarachnoid hemorrhage. AJNR Am J Neuroradiol. 2000 Jun-Jul;21(6):1011-5.
  2. Chaudhary SR, Ko N, Dillon WP, Yu MB, Liu S, Criqui GI, et al. Prospective evaluation of multidetector-row CT angiography for the diagnosis of vasospasm following subarachnoid hemorrhage: a comparison with digital subtraction angiography. Cerebrovasc Dis. 2008;25(1-2): 144-50. https://doi.org/10.1159/000112325
  3. Cloft HJ, Joseph GJ, Dion JE. Risk of cerebral angiography in patients with subarachnoid hemorrhage, cerebral aneurysm, and arteriovenous malformation: a meta-analysis. Stroke. 1999 Feb;30(2):317-20. https://doi.org/10.1161/01.STR.30.2.317
  4. Dorsch NW, Young N, Kingston RJ, Compton JS. Early experience with spiral CT in the diagnosis of intracranial aneurysms. Neurosurgery. 1995 Jan;36(1):230-6; discussion 236-8. https://doi.org/10.1227/00006123-199501000-00037
  5. Earnest F 4th, Forbes G, Sandok BA, Piepgras DG, Faust RJ, Ilstrup DM, et al. Complications of cerebral angiography: prospective assessment of risk. AJR Am J Roentgenol. 1984 Feb;142(2):247-53. https://doi.org/10.2214/ajr.142.2.247
  6. Ferguson SD, Rosen DS, Bardo D, Macdonald RL. Arterial diameters on catheter and computed tomographic angiography. World Neurosurg. 2010 Mar;73(3): 165-73; discussion e25. https://doi.org/10.1016/j.surneu.2008.12.017
  7. Heiserman JE, Dean BL, Hodak JA, Flom RA, Bird CR, Drayer BP, et al. Neurologic complications of cerebral angiography. AJNR Am J Neuroradiol. 1994 Sep;15(8): 1401-7; discussion 1408-11.
  8. Levi CR, O'Malley HM, Fell G, Roberts AK, Hoare MC, Royle JP, et al. Transcranial Doppler detected cerebral microembolism following carotid endarterectomy. High microembolic signal loads predict postoperative cerebral ischaemia. Brain. 1997 Apr;120 (Pt 4):621-9. https://doi.org/10.1093/brain/120.4.621
  9. Okada Y, Shima T, Nishida M, Yamane K, Hatayama T, Yamanaka C, et al. Comparison of transcranial Doppler investigation of aneurysmal vasospasm with digital subtraction angiographic and clinical findings. Neurosurgery. 1999 Sep;45(3):443-9; discussion 449-50. https://doi.org/10.1097/00006123-199909000-00005
  10. Otawara Y, Ogasawara K, Ogawa A, Sasaki M, Takahashi K. Evaluation of vasospasm after subarachnoid hemorrhage by use of multislice computed tomographic angiography. Neurosurgery. 2002 Oct;51(4):939-42; discussion 942-3. https://doi.org/10.1227/00006123-200210000-00015
  11. Pryor JC, Setton A, Nelson PK, Berenstein A. Complications of diagnostic cerebral angiography and tips on avoidance. Neuroimaging Clin N Am. 1996 Aug;6(3):751-8.
  12. Shankar JJ, Tan IY, Krings T, Terbrugge K, Agid R. CT angiography for evaluation of cerebral vasospasm following acute subarachnoid haemorrhage. Neuroradiology. 2012 Mar;54(3):197-203. https://doi.org/10.1007/s00234-011-0876-9
  13. Sloan MA, Haley EC Jr, Kassell NF, Henry ML, Stewart SR, Beskin RR, et al. Sensitivity and specificity of transcranial Doppler ultrasonography in the diagnosis of vasospasm following subarachnoid hemorrhage. Neurology. 1989 Nov;39(11):1514-8. https://doi.org/10.1212/WNL.39.11.1514
  14. Takagi R, Hayashi H, Kobayashi H, Kumazaki T, Isayama K, Ikeda Y, et al. Three-dimensional CT angiography of intracranial vasospasm following subarachnoid haemorrhage. Neuroradiology. 1998 Oct;40(10): 631-5. https://doi.org/10.1007/s002340050654
  15. Tamatani S, Sasaki O, Takeuchi S, Fujii Y, Koike T, Tanaka R. Detection of delayed cerebral vasospasm, after rupture of intracranial aneurysms, by magnetic resonance angiography. Neurosurgery. 1997 Apr;40(4):748-53; discussion 753-4. https://doi.org/10.1097/00006123-199704000-00017
  16. Treggiari-Venzi MM, Suter PM, Romand JA. Review of medical prevention of vasospasm after aneurysmal subarachnoid hemorrhage: a problem of neurointensive care. Neurosurgery. 2001 Feb;48(2):249-61; discussion 261-2. https://doi.org/10.1227/00006123-200102000-00001
  17. Vernieri F, Pasqualetti P, Passarelli F, Rossini PM, Silvestrini M. Outcome of carotid artery occlusion is predicted by cerebrovascular reactivity. Stroke. 1999 Mar;30(3):593-8. https://doi.org/10.1161/01.STR.30.3.593
  18. Waugh JR, Sacharias N. Arteriographic complications in the DSA era. Radiology. 1992 Jan;182(1):243-6. https://doi.org/10.1148/radiology.182.1.1727290
  19. Wintermark M, Ko NU, Smith WS, Liu S, Higashida RT, Dillon WP. Vasospasm after subarachnoid hemorrhage: utility of perfusion CT and CT angiography on diagnosis and management. AJNR Am J Neuroradiol. 2006 Jan;27(1):26-34.
  20. Yoon DY, Choi CS, Kim KH, Cho BM. Multidetector-row CT angiography of cerebral vasospasm after aneurysmal subarachnoid hemorrhage: comparison of volume-rendered images and digital subtraction angiography. AJNR Am J Neuroradiol. 2006 Feb;27(2): 370-7.