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Improved Turnaround Times | Median time to first decision: 12 days

Research ArticleNeurointervention

Subarachnoid Hyperattenuation on Flat Panel Detector–Based Conebeam CT Immediately after Uneventful Coil Embolization of Unruptured Intracranial Aneurysms

Y. Shinohara, M. Sakamoto, H. Takeuchi, T. Uno, T. Watanabe, T. Kaminou and T. Ogawa
American Journal of Neuroradiology March 2013, 34 (3) 577-582; DOI: https://doi.org/10.3174/ajnr.A3243
Y. Shinohara
aFrom the Division of Radiology (Y.S., T.K., T.O.), Department of Pathophysiological Therapeutic Science
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M. Sakamoto
bDivision of Neurosurgery (M.S., T.U., T.W.), Department of Brain and Neurosciences, Faculty of Medicine, Tottori University, Yonago, Japan
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H. Takeuchi
cDepartment of Neurosurgery (H.T.), Nojima Hospital, Kurayoshi, Japan.
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T. Uno
bDivision of Neurosurgery (M.S., T.U., T.W.), Department of Brain and Neurosciences, Faculty of Medicine, Tottori University, Yonago, Japan
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T. Watanabe
bDivision of Neurosurgery (M.S., T.U., T.W.), Department of Brain and Neurosciences, Faculty of Medicine, Tottori University, Yonago, Japan
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T. Kaminou
aFrom the Division of Radiology (Y.S., T.K., T.O.), Department of Pathophysiological Therapeutic Science
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T. Ogawa
aFrom the Division of Radiology (Y.S., T.K., T.O.), Department of Pathophysiological Therapeutic Science
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    Fig. 1.

    A 63-year-old man with an unruptured 6-mm AcomA complex aneurysm. The patient underwent endovascular embolization for the aneurysm with the guiding catheter in the left ICA. The aneurysm was coiled with balloon assistance. The total volume of contrast medium injected was approximately 300 mL. A, DSA after embolization reveals coil mesh in the left A1-A2 bifurcation (black arrow). B, CBCT immediately after the procedure shows focal subarachnoid hyperattenuation in the left superior frontal sulcus (white arrow). C, Conventional CT 45 minutes after the procedure also shows focal subarachnoid hyperattenuation in the left superior frontal sulcus (white arrow). D, DWI reveals no abnormal high-intensity area indicating acute infarction. E, FLAIR imaging shows no high signal intensity in the sulci indicating SAH. F, T2*-weighted imaging demonstrates no low signal intensity in the sulci indicating SAH. These MR images were obtained 111 minutes after the procedure.

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    Fig. 2.

    A 42-year-old woman with an unruptured 7-mm AcomA aneurysm. The patient underwent endovascular embolization for the aneurysm with the guiding catheter in the left ICA. The aneurysm was coiled with balloon assistance. The total volume of contrast medium injected was approximately 250 mL. A, Postembolization DSA of the left ICA injection reveals coil mesh in the AcomA region (black arrow). Notice that the bilateral distal ACA is symmetrically visualized, presumably due to the hypoplastic right A1 segment. B and C, Axial and coronal CBCT scans, respectively, immediately after the procedure show focal subarachnoid hyperattenuation in the bilateral superior frontal sulci (black arrows). D, DWI reveals no abnormal high-intensity area indicating acute infarction. E, FLAIR imaging shows no high signal intensity in the sulci indicating SAH. F, T2*-weighted imaging demonstrates no low signal intensity in the sulci indicating SAH. These MR images were obtained 2 days after the procedure.

Tables

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  • Relationship between each parameter and subarachnoid hyperattenuation on FPD-based CBCT immediately after coil embolization

    ParameterSubarachnoid HyperattenuationP Value
    +−
    Location of aneurysm
        ICA419.0728
        MCA02
        AcomA33
        ACA20
        VB03
    Size of aneurysm (mm)
        <5012<.05
        5–10413
        10–1510
        ≥1542
    Amount of contrast medium (mL)
        <150017<.001
        150–25048
        ≥25052
    Balloon assistance
        Performed312.567
        Not performed615
    Stent assistance
        Performed45.150
        Not performed522
    • Note:—+ indicates presence; −, absence.

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American Journal of Neuroradiology: 34 (3)
American Journal of Neuroradiology
Vol. 34, Issue 3
1 Mar 2013
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Cite this article
Y. Shinohara, M. Sakamoto, H. Takeuchi, T. Uno, T. Watanabe, T. Kaminou, T. Ogawa
Subarachnoid Hyperattenuation on Flat Panel Detector–Based Conebeam CT Immediately after Uneventful Coil Embolization of Unruptured Intracranial Aneurysms
American Journal of Neuroradiology Mar 2013, 34 (3) 577-582; DOI: 10.3174/ajnr.A3243

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Subarachnoid Hyperattenuation on Flat Panel Detector–Based Conebeam CT Immediately after Uneventful Coil Embolization of Unruptured Intracranial Aneurysms
Y. Shinohara, M. Sakamoto, H. Takeuchi, T. Uno, T. Watanabe, T. Kaminou, T. Ogawa
American Journal of Neuroradiology Mar 2013, 34 (3) 577-582; DOI: 10.3174/ajnr.A3243
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