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Lee, Choi, Ryoo, You, Choi, and Kim: Multidetector-Row CT Angiography of Cerebral Vasospasm after Aneurysmal Subarachnoid Hemorrhage: Comparison of Bone Subtraction and Standard CT Angiography with Digital Subtraction Angiography
Neuroradiology
Case Report

Journal of the Korean Society of Radiology 2011; 65(4): 325-331.

Published online: 31 October 2011

DOI: https://doi.org/10.3348/jksr.2011.65.4.325

Multidetector-Row CT Angiography of Cerebral Vasospasm after Aneurysmal Subarachnoid Hemorrhage: Comparison of Bone Subtraction and Standard CT Angiography with Digital Subtraction Angiography

Yong Hee Lee, MD1, Dae Seob Choi, MD1, 2, Jae Wook Ryoo, MD3, Jin Jong You, MD1, Ho Cheol Choi, MD1, Ji Eun Kim, MD1

1Department of Radiology, Gyeongsang National University Hospital, Jinju, Korea.

2Gyeongsang Institute of Health Science, Gyeongsang National University School of Medicine, Jinju, Korea.

3Department of Radiology, Samsung Seoul Hospital, Seoul, Korea.

Corresponding author: Dae Seob Choi, MD. Department of Radiology, Gyeongsang National University Hospital, 79 Gangnam-ro, Jinju 660-702, Korea. Tel. 82-55-750-8211, Fax. 82-55-758-1568, choids@gnu.ac.kr

Received 13 June 2011       Accepted 4 August 2011

Copyright © 2011 The Korean Society of Radiology

Abstract

Purpose

To evaluate the usefulness of multidetector-row CT angiography (MDCTA) for the diagnosis of cerebral vasospasm after aneurysmal subarachnoid hemorrhage (SAH) by comparison of digital subtraction angiography (DSA) and to compare the bone subtraction CT angiography (BS-CTA) and standard CT angiography (S-CTA).

Materials and Methods

Thirty-three patients who were treated with intraarterial nimodipine infusion for the cerebral vasospasm after aneurysmal SAH were evaluated with MDCTA and DSA. BS-CTA images were reconstructed from the S-CTA and unenhanced CT source images. A total of 207 vascular segments were evaluated. A four-step scale for the degree of stenosis was applied for each segment. With DSA as the standard images, BS-CTA and S-CTA images were comparied.

Results

On DSA, 56 segments (27%) presented vasospasm. Concordance between the DSA and S-CTA and between DSA and BS-CTA were 94.7% and 82.1%, respectively. Overestimation for the degree of stenosis was shown in 37 segments on BS-CTA and in 8 segments on S-CTA, but underestimated segments were only shown on S-CTA (n = 4).

Conclusion

MDCTA with standard technique seems to be a useful imaging tool for the evaluation of the cerebral vasospasm after aneurysmal SAH. However, BS-CTA is not needed because of additional radiation and overestimation of the degree of stenosis.

Keywords: Intracranial Aneurysm, Subarachnoid Hemorrhage, Vasospasm, Intracranial, Cerebral Angiography, Tomography, X-Ray Computed

Figures and Tables

Fig. 1

Signal joint T-cell receptor excision circle (sjTREC) levels in blood (n=31) (A), thymus (n=31) (B), and spleen (n=33) (C) tissues.

kjlm-40-44-g001
Table 1

Descriptive statistics of sjTREC levels measured in three tissue samples

kjlm-40-44-i001

sjTREC, signal joint T-cell receptor excision circle; SD, standard deviation; SE, standard error.

a)Log[sjTREC per µg DNA]; b)Significant at P<0.05.

Table 2

Results of estimated age using samples recovered from actual forensic cases

kjlm-40-44-i002

sjTREC, signal joint T-cell receptor excision circle.

a)Two fragment samples were collected from different sites in each thymus.

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