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Research ArticleBrain

Comparison of 2D and 3D Digital Subtraction Angiography in Evaluation of Intracranial Aneurysms

Takeshi Sugahara, Yukunori Korogi, Kouji Nakashima, Satoshi Hamatake, Shin Honda and Mutsumasa Takahashi
American Journal of Neuroradiology October 2002, 23 (9) 1545-1552;
Takeshi Sugahara
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Yukunori Korogi
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Kouji Nakashima
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Satoshi Hamatake
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Shin Honda
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Mutsumasa Takahashi
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    Fig 1.

    Images from the case of a 64-year-old female patient with multiple aneurysms.

    A, Anteroposterior standard 2D DSA shows right anterior (arrow) and posterior communicating (double arrows) artery aneurysms, but the right middle cerebral artery aneurysm cannot be visualized (arrowhead).

    B, Lateral standard 2D DSA shows right anterior (arrow) and posterior communicating (double arrows) artery aneurysms, but the right middle cerebral artery aneurysm cannot be visualized (arrowhead).

    C, Rotational DSA image, which can be seen stereoscopically, clearly shows the relationship of the right anterior (arrow) and posterior communicating (double arrows) artery aneurysms to the neighboring vessels and to the aneurysmal necks. The right middle cerebral artery aneurysm (arrowhead) can be seen, but the relationship to the neighboring vessels and the aneurysmal neck are obscured by the superimposition of the surrounding arteries. Note that minimal misregistrations are observed.

    D, MIP image clearly shows the relationship of the right anterior (arrow) and posterior communicating (double arrows) artery aneurysms to the neighboring vessels and to the aneurysmal necks. The right middle cerebral artery aneurysm (arrowhead) can be seen, but the relationship to the neighboring vessels and the aneurysmal neck are obscured by the superimposition of the surrounding arteries. Minimal misregistrations do not create artifacts.

    E, SSD image clearly shows the relationship of the right anterior (arrow) and posterior communicating (double arrows) artery aneurysms to the neighboring vessels and to the aneurysmal necks. The right middle cerebral artery aneurysm (arrowhead) is seen, and the relationship to the neighboring vessels and aneurysmal neck are easily recognized. Minimal misregistrations do not create artifacts.

  • Fig 2.
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    Fig 2.

    Images from the case of a 67-year-old female patient with a right middle cerebral artery aneurysm.

    A, Anteroposterior standard 2D DSA image. The aneurysm can be identified (arrow), but the identification of the presence of aneurysmal lobulation and the relationship to neighboring arteries is difficult.

    B, Lateral standard 2D DSA image. The aneurysm can be identified (arrow), but the presence of aneurysmal lobulation and the relationship to neighboring arteries is difficult to discern.

    C, Rotational DSA image, which can be seen stereoscopically, clearly shows the aneurysm (arrow), but the superimposition of many neighboring arteries makes it difficult to evaluate the presence of aneurysmal lobulation and the relationship to neighboring arteries.

    D, MIP image clearly shows the aneurysmal lobulation and relationship to neighboring arteries (arrow).

    E, SSD image is especially clear in showing the aneurysmal lobulation and relationship to neighboring arteries.

  • Fig 3.
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    Fig 3.

    Images from the case of a 61-year-old male patient with a left anterior communicating artery aneurysm.

    A, Lateral standard 2D DSA image. Few image artifacts are noted.

    B, Rotational DSA image. Image artifacts are severe.

    C, MIP image. Image artifacts create blurring (arrowheads).

    D, SSD image. Image artifacts create abnormal irregular structures (arrowheads).

Tables

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    TABLE 1:

    Location of aneurysms treated

    LocationAneurysms (n)
    Anterior communicating artery11
    Posterior communicating artery10
    Middle cerebral artery9
    Posterior inferior cerebellar artery3
    Ophthalmic artery2
    Basilar artery2
    Internal cerebral artery1
    Anterior choroidal artery1
    Pericarosal artery1
    Total40
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    TABLE 2:

    The data of image analysis

    Presence ofAneurysmPresence of LobulationVisualization of Aneurysmal NeckRelationship to Neighboring ArteryOverall Image Quality
    DSA4.50 + 0.923.27 + 1.272.50 + 0.882.37 + 0.943.90 + 0.31†‡§
    Rotation4.83 + 0.453.83 + 1.233.60 + 0.65*3.57 + 0.70*3.56 + 0.54§
    MIP4.93 + 0.27*3.94 + 1.08*3.86 + 0.39*3.86 + 0.43*†3.44 + 0.54§
    SSD5.00 + 0.00*4.54 + 0.99*†‡4.00 + 0.00*†4.00 + 0.00*†3.06 + 0.25
    • Note.—DSA indicates digital subtraction angiography; MIP, maximum intensity projection; SSD, surface shaded display.

    • * Value is significantly greater than that of DSA.

    • † Value is significantly greater than that of rotational DSA.

    • ‡ Value is significantly greater than that of MIP.

    • § Value is significantly greater than that of SSD.

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American Journal of Neuroradiology: 23 (9)
American Journal of Neuroradiology
Vol. 23, Issue 9
1 Oct 2002
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Cite this article
Takeshi Sugahara, Yukunori Korogi, Kouji Nakashima, Satoshi Hamatake, Shin Honda, Mutsumasa Takahashi
Comparison of 2D and 3D Digital Subtraction Angiography in Evaluation of Intracranial Aneurysms
American Journal of Neuroradiology Oct 2002, 23 (9) 1545-1552;

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Comparison of 2D and 3D Digital Subtraction Angiography in Evaluation of Intracranial Aneurysms
Takeshi Sugahara, Yukunori Korogi, Kouji Nakashima, Satoshi Hamatake, Shin Honda, Mutsumasa Takahashi
American Journal of Neuroradiology Oct 2002, 23 (9) 1545-1552;
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