Diagnosis and Treatment of Intracranial Aneurysms with 3-dimensional Digital Subtraction Angiography

You, Seung Hoon; Hong, Seung Chyul; Lee, Jung Il; Kim, Jong Soo; Kim, Jong Hyun

Abstract

OBJECTIVES
To evaluate the diagnostic accuracy of three-dimensional digital subtraction angiography in the surgical or interventional treatment of intracranial aneurysms. MATERIAL AND METHODS: We reviewed the clinical records, radiological findings, and surgical results of seventy-two patients with eight-five aneurysms who had undergone 2-dimensional digital subtraction angiography (2-D DSA) and 3-D DSA as the diagnostic evaluation. 3-D images were compared with 2-D images and surgical or interventional results. The shape of the aneurysms, their necks, and their relationships to the parent vessels and other branches were evaluated.
RESULTS
The existence of the aneurysms was diagnosed exclusively by 3-D DSA in 13 patients. The site (n=27) and the shape (n=15) of the aneurysms were evaluated more accurately with 3-D DSA than with 2-D DSA images. Depiction of aneurysmal necks and their relationships to the parent vessels was clearer with 3-D DSA images than with 2-D DSA images, especially in cases of the distal internal carotid artery aneurysms.
CONCLUSION
With its advantages, such as unlimited projection, similarity to surgical view, and high resolution especially in the cavernous portion of ICA, the 3-D DSA provides more valuable information in the planning the surgical or interventional treatments of cerebral aneurysms.