Additional value of 3D rotational angiography in angiographically negative Aneurysmal subarachnoid hemorrhage: How negative is negative?

被引:44
作者
van Rooij, W. J. [1 ]
Peluso, J. P. P. [1 ]
Sluzewski, M. [1 ]
Beute, G. N. [2 ]
机构
[1] St Elisabeth Ziekenkuis, Dept Radiol, NL-5022 GC Tilburg, Netherlands
[2] St Elisabeth Ziekenkuis, Dept Neurosurg, NL-5022 GC Tilburg, Netherlands
关键词
D O I
10.3174/ajnr.A0972
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
BACKGROUND AND PURPOSE: In some patients with nonperimesencephalic nontraumatic subarachnoid hemorrhage (aneurysmal SAH), no aneurysm can be found on digital subtraction angiography (DSA), and repeat DSA is advocated. 3D rotational angiography (3DRA) is considered superior to DSA in the detection of small intracranial aneurysms. In this study, we assessed the additional diagnostic value of 3DRA in detecting DSA-occult aneurysms in 23 patients with aneurysmal SAH. MATERIALS AND METHODS: Between January 2006 and September 2007, 298 patients with suggested ruptured intracranial aneurysm were referred for DSA, and in 98 patients, DSA was negative. Of these 98 patients, 28 had aneurysmal SAH, and in 23 of these additional 3DRA was performed in the same or in a repeat angiographic procedure. RESULTS: In 18 of 23 patients (78%), a ruptured small aneurysm was diagnosed on additional 3DRA. The location of 18 aneurysms was the anterior communicating artery (n = 11), the middle cerebral artery (n = 3), the posterior communicating artery (n = 2), the ophthalmic artery (n = 1), and the posterior inferior cerebellar artery (n = 1). Aneurysm size was 3 mm in 4, 2 mm in 9, and 1 mm in 5. Of 18 aneurysms, 9 were treated with coil placement; 7 with surgical clipping; and 2 were not treated. CONCLUSION: In this study, 18 of 23 (78%) patients with negative findings on DSA had a small ruptured aneurysm when studied with 3DRA. These were most commonly located on the anterior communicating artery.
引用
收藏
页码:962 / 966
页数:5
相关论文
共 21 条
[1]   Acute subarachnoid hemorrhage: using 64-slice multidetector CT angiography to "triage" patients' treatment [J].
Agid, R. ;
Lee, S. K. ;
Willinsky, R. A. ;
Farb, R. I. ;
terBrugge, K. G. .
NEURORADIOLOGY, 2006, 48 (11) :787-794
[2]   Fenestrations of the anterior communicating artery: Incidence on 3D angiography and relationship to aneurysms [J].
de Gast, A. N. ;
van Rooij, W. J. ;
Sluzewski, M. .
AMERICAN JOURNAL OF NEURORADIOLOGY, 2008, 29 (02) :296-298
[3]   Nontraumatic subarachnoid hemorrhage: Value of repeat angiography [J].
deRochemont, RD ;
Heindel, W ;
Wesselmann, C ;
Kruger, K ;
Lanfermann, H ;
Ernestus, RI ;
Neveling, M ;
Lackner, K .
RADIOLOGY, 1997, 202 (03) :798-800
[4]   REPEAT CEREBRAL PAN-ANGIOGRAPHY IN SUBARACHNOID HEMORRHAGE OF UNKNOWN ETIOLOGY [J].
GILBERT, JW ;
LEE, C ;
YOUNG, B .
SURGICAL NEUROLOGY, 1990, 33 (01) :19-21
[5]  
Hirai T, 2003, AM J NEURORADIOL, V24, P1067
[6]  
Hochmuth A, 2002, AM J NEURORADIOL, V23, P1199
[7]  
Houben M P W A, 2002, Ned Tijdschr Geneeskd, V146, P804
[8]   Occult ruptured cerebral aneurysms revealed by repeat angiography: result from a large retrospective study [J].
Inamasu, J ;
Nakamura, Y ;
Saito, R ;
Horiguchi, T ;
Kuroshima, Y ;
Mayanagi, K ;
Orii, M ;
Ichikizaki, K .
CLINICAL NEUROLOGY AND NEUROSURGERY, 2003, 106 (01) :33-37
[9]   Angiogram-negative subarachnoid hemorrhage in the era of three dimensional rotational angiography [J].
Ishihara, Hideyuki ;
Kato, Shoichi ;
Akimura, Tatsuo ;
Suehiro, Eiichi ;
Oku, Takayuki ;
Suzuki, Michiyasu .
JOURNAL OF CLINICAL NEUROSCIENCE, 2007, 14 (03) :252-255
[10]   SURGERY FOR ANGIOGRAPHICALLY OCCULT CEREBRAL ANEURYSMS [J].
JAFAR, JJ ;
WEINER, HL .
JOURNAL OF NEUROSURGERY, 1993, 79 (05) :674-679