Case series of 64 slice computed tomography-computed tomographic angiography with 3D reconstruction to diagnose symptomatic cerebral aneurysms: new standard of care?

CT angiography (CTA) has improved significantly over the past few years such that the reconstructed images of the cerebral arteries may now be equivalent to conventional digital angiography. The new technology of 64 slice multi-detector CTA can reconstruct detailed images that can reliably identify...

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Main Authors: Dietrich Jehle, Floria Chae, Jonathan Wai, Sam Cloud, David Pierce, Michael Meyer
Format: Article
Language:English
Published: MDPI AG 2012-02-01
Series:Neurology International
Subjects:
Online Access:http://www.pagepress.org/journals/index.php/ni/article/view/2066
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spelling doaj-48700b5f7fe441a7ba265345cd6214872021-01-02T13:43:34ZengMDPI AGNeurology International2035-83852035-83772012-02-0141e2e210.4081/ni.2012.e22009Case series of 64 slice computed tomography-computed tomographic angiography with 3D reconstruction to diagnose symptomatic cerebral aneurysms: new standard of care?Dietrich Jehle0Floria Chae1Jonathan Wai2Sam Cloud3David Pierce4Michael Meyer5State University of New York at Buffalo, Department of Emergency Medicine, NYState University of New York at Buffalo, Department of Emergency Medicine, NYState University of New York at Buffalo, Department of Emergency Medicine, NYState University of New York at Buffalo, Department of Emergency Medicine, NYState University of New York at Buffalo, Department of Emergency Medicine, NYState University of New York at Buffalo, Department of Emergency Medicine, NYCT angiography (CTA) has improved significantly over the past few years such that the reconstructed images of the cerebral arteries may now be equivalent to conventional digital angiography. The new technology of 64 slice multi-detector CTA can reconstruct detailed images that can reliably identify small cerebral aneurysms, even those &lt;3mm. In addition, it is estimated that CT followed by lumbar puncture (LP) misses up to 4% of symptomatic aneurysms. We present a series of cases that illustrates how CT followed by CTA may be replacing CT-LP as the standard of care in working up patients for symptomatic cerebral aneurysms and the importance of performing three dimensional (3D) reconstructions. A series of seven cases of symptomatic cerebral aneurysms were identified that illustrate the sensitivity of CT-CTA <em>versus</em> CT-LP and the importance of 3D reconstruction in identifying these aneurysms. Surgical treatment was recommended for 6 of the 7 patients with aneurysms and strict hypertension control was recommended for the seventh patient. Some of these patients demonstrated subarachnoid hemorrhage on presentation while others had negative LPs. A number of these patients with negative LPs were clearly symptomatic from their aneurysms. At least one of these cerebral aneurysms was not apparent on CTA without 3D reconstruction. 3D reconstruction of CTA is crucial to adequately identify cerebral aneurysms. This case series helps reinforce the importance of 3D reconstruction. There is some data to suggest that 64 slice CT-CTA may be equivalent or superior to CT-LP in the detection of symptomatic cerebral aneurysms.http://www.pagepress.org/journals/index.php/ni/article/view/2066subarachnoid hemorrhage, acute onset headache, computed tomography, computed tomographic angiography, lumbar puncture
collection DOAJ
language English
format Article
sources DOAJ
author Dietrich Jehle
Floria Chae
Jonathan Wai
Sam Cloud
David Pierce
Michael Meyer
spellingShingle Dietrich Jehle
Floria Chae
Jonathan Wai
Sam Cloud
David Pierce
Michael Meyer
Case series of 64 slice computed tomography-computed tomographic angiography with 3D reconstruction to diagnose symptomatic cerebral aneurysms: new standard of care?
Neurology International
subarachnoid hemorrhage, acute onset headache, computed tomography, computed tomographic angiography, lumbar puncture
author_facet Dietrich Jehle
Floria Chae
Jonathan Wai
Sam Cloud
David Pierce
Michael Meyer
author_sort Dietrich Jehle
title Case series of 64 slice computed tomography-computed tomographic angiography with 3D reconstruction to diagnose symptomatic cerebral aneurysms: new standard of care?
title_short Case series of 64 slice computed tomography-computed tomographic angiography with 3D reconstruction to diagnose symptomatic cerebral aneurysms: new standard of care?
title_full Case series of 64 slice computed tomography-computed tomographic angiography with 3D reconstruction to diagnose symptomatic cerebral aneurysms: new standard of care?
title_fullStr Case series of 64 slice computed tomography-computed tomographic angiography with 3D reconstruction to diagnose symptomatic cerebral aneurysms: new standard of care?
title_full_unstemmed Case series of 64 slice computed tomography-computed tomographic angiography with 3D reconstruction to diagnose symptomatic cerebral aneurysms: new standard of care?
title_sort case series of 64 slice computed tomography-computed tomographic angiography with 3d reconstruction to diagnose symptomatic cerebral aneurysms: new standard of care?
publisher MDPI AG
series Neurology International
issn 2035-8385
2035-8377
publishDate 2012-02-01
description CT angiography (CTA) has improved significantly over the past few years such that the reconstructed images of the cerebral arteries may now be equivalent to conventional digital angiography. The new technology of 64 slice multi-detector CTA can reconstruct detailed images that can reliably identify small cerebral aneurysms, even those &lt;3mm. In addition, it is estimated that CT followed by lumbar puncture (LP) misses up to 4% of symptomatic aneurysms. We present a series of cases that illustrates how CT followed by CTA may be replacing CT-LP as the standard of care in working up patients for symptomatic cerebral aneurysms and the importance of performing three dimensional (3D) reconstructions. A series of seven cases of symptomatic cerebral aneurysms were identified that illustrate the sensitivity of CT-CTA <em>versus</em> CT-LP and the importance of 3D reconstruction in identifying these aneurysms. Surgical treatment was recommended for 6 of the 7 patients with aneurysms and strict hypertension control was recommended for the seventh patient. Some of these patients demonstrated subarachnoid hemorrhage on presentation while others had negative LPs. A number of these patients with negative LPs were clearly symptomatic from their aneurysms. At least one of these cerebral aneurysms was not apparent on CTA without 3D reconstruction. 3D reconstruction of CTA is crucial to adequately identify cerebral aneurysms. This case series helps reinforce the importance of 3D reconstruction. There is some data to suggest that 64 slice CT-CTA may be equivalent or superior to CT-LP in the detection of symptomatic cerebral aneurysms.
topic subarachnoid hemorrhage, acute onset headache, computed tomography, computed tomographic angiography, lumbar puncture
url http://www.pagepress.org/journals/index.php/ni/article/view/2066
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