J Korean Neurosurg Soc.  2021 Sep;64(5):726-731. 10.3340/jkns.2020.0332.

Source Image Based New 3D Rotational Angiography for Differential Diagnosis between the Infundibulum and an Internal Carotid Artery Aneurysm : Pilot Study

  • 1Department of Neurosurgery, International St. Mary’s Hospital, College of Medicine, Catholic Kwandong University, Incheon, Korea
  • 2Department of Radiology, Ajou University Hospital, College of Medicine, Ajou University, Suwon, Korea
  • 3Department of Radiology, College of Medicine, Kangwon National University, Chuncheon, Korea
  • 4Department of Radiology, Bundang Jesaeng General Hospital, Sungnam, Korea
  • 5Department of Neurosurgery, Ewha Womans University Seoul Hospital, College of Medicine, Ewha Womans University, Seoul, Korea
  • 6Department of Neurosurgery, Yongin Severance Hospital, College of Medicine, Yonsei University, Yongin, Korea


: Distinguishing between an infundibulum and a true aneurysm is clinically important. This study aimed to evaluate whether using source image based new three-dimensional rotational angiography (S-n3DRA) can increase the rate of aneurysm detection and improve distinction between a true aneurysm and an infundibulum.
: Twenty-two consecutive patients with 23 lesions, were evaluated by time-of-flight (TOF) magnetic resonance angiography (MRA), S-n3DRA, and digital subtraction angiography (DSA). The data were retrospectively and independently reviewed by two neurointerventionists, and the diagnoses based on TOF MRA, S-n3DRA, and DSA were compared. The diagnostic efficacy (interobserver agreement and diagnostic performance) of S-n3DRA was compared with that of TOF MRA.
: S-n3DRA showed higher interobserver agreement (κ=0.923) than TOF MRA (κ=0.465) and significantly higher accuracy than MRA in distinguishing an aneurysm from an infundibulum (p=0.0039).
: Compared to MRA, S-n3DRA could provide better screening accuracy and information for distinguishing an aneurysm from an infundibulum. Therefore, S-n3DRA has the potential to reduce the need for DSA.


Source image based new three-dimensional rotational angiogram; Time-of-flight magnetic resonance angiography; Digital subtraction angiography; Intracranial aneurysm; Infundibulum
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