J Korean Soc Radiol.  2011 Oct;65(4):325-331. 10.3348/jksr.2011.65.4.325.

Multidetector-Row CT Angiography of Cerebral Vasospasm after Aneurysmal Subarachnoid Hemorrhage: Comparison of Bone Subtraction and Standard CT Angiography with Digital Subtraction Angiography

• Lee YH
• Choi DS
• Ryoo JW
• You JJ
• Choi HC
• Kim JE

• KMID: 2002932
• DOI: http://doi.org/10.3348/jksr.2011.65.4.325

Abstract

PURPOSE
To evaluate the usefulness of multidetector-row CT angiography (MDCTA) for the diagnosis of cerebral vasospasm after aneurysmal subarachnoid hemorrhage (SAH) by comparison of digital subtraction angiography (DSA) and to compare the bone subtraction CT angiography (BS-CTA) and standard CT angiography (S-CTA).
MATERIALS AND METHODS
Thirty-three patients who were treated with intraarterial nimodipine infusion for the cerebral vasospasm after aneurysmal SAH were evaluated with MDCTA and DSA. BS-CTA images were reconstructed from the S-CTA and unenhanced CT source images. A total of 207 vascular segments were evaluated. A four-step scale for the degree of stenosis was applied for each segment. With DSA as the standard images, BS-CTA and S-CTA images were comparied.
RESULTS
On DSA, 56 segments (27%) presented vasospasm. Concordance between the DSA and S-CTA and between DSA and BS-CTA were 94.7% and 82.1%, respectively. Overestimation for the degree of stenosis was shown in 37 segments on BS-CTA and in 8 segments on S-CTA, but underestimated segments were only shown on S-CTA (n = 4).
CONCLUSION
MDCTA with standard technique seems to be a useful imaging tool for the evaluation of the cerebral vasospasm after aneurysmal SAH. However, BS-CTA is not needed because of additional radiation and overestimation of the degree of stenosis.

MeSH Terms

Aneurysm
Angiography
Angiography, Digital Subtraction
Cerebral Angiography
Constriction, Pathologic
Humans
Intracranial Aneurysm
Nimodipine
Subarachnoid Hemorrhage
Tomography, X-Ray Computed
Vasospasm, Intracranial
Nimodipine

Figure

• 

  Fig. 1 Signal joint T-cell receptor excision circle (sjTREC) levels in blood (n=31) (A), thymus (n=31) (B), and spleen (n=33) (C) tissues.

Reference

1. Weir B, Grace M, Hansen J, Rothberg C. Time course of vasospasm in man. J Neurosurg. 1978; 48:173–178.

2. 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; 39:1514–1518.

3. Schwartz RB, Tice HM, Hooten SM, Hsu L, , Liu F, van Zelm MC, et al. Estimating human age from T-cell DNA rearrangements. Curr Biol. 2010; 20:R970–R971.

4. Ou XL, Gao J, Wang H, et al. Predicting human age with bloodstains by sjTREC quantification. PLoS One. 2012; 7:e42412.

5. Strobel P, Moritz R, Leite MI, et al. The ageing and myasthenic thymus: a morphometric study validating a standard procedure in the histological workup of thymic specimens. J Neuroimmunol. 2008; 201-202:64–73.

6. Zhang L, Lewin SR, Markowitz M, et al. Measuring recent thymic emigrants in blood of normal and HIV-1-infected individuals before and after effective therapy. J Exp Med. 1999; 190:725–732.

7. Cho S, Ge J, Seo SB, et al. Age estimation via quantification of signal-joint T cell receptor excision circles in Koreans. Leg Med (Tokyo). 2014; 16:135–138.

8. Jamieson BD, Douek DC, Killian S, et al. Generation of functional thymocytes in the human adult. Immunity. 1999; 10:569–575.

9. Douek DC, McFarland RD, Keiser PH, et al. Changes in thymic function with age and during the treatment of HIV infection. Nature. 1998; 396:690–695.