Related Experiment Video
Updated: Jun 21, 2026
Simulator Training for Endovascular Neurosurgery
Published on: May 6, 2020
Three-dimensional volume-rendering technique in the angiographic follow-up of intracranial aneurysms embolized with
Bing Zhou1, Ming-Hua Li, Wu Wang
1Department of Diagnostic and Interventional Radiology, Shanghai Sixth People's Hospital, Shanghai Jiao Tong University, Shanghai, China.
Insights
Three-dimensional volume-rendering technique (VRT) offers superior detection of aneurysm remnants compared to 2D digital subtraction angiography and rotational angiography. This advanced imaging is also beneficial for identifying parent artery stenosis in follow-up assessments.
Area of Science:
- Neuroradiology
- Medical Imaging
- Endovascular Surgery
Background:
- Intracranial aneurysms treated with coil embolization require regular follow-up to assess treatment efficacy and detect potential complications.
- Digital subtraction (DS) angiography, including 2D and rotational techniques, is commonly used for follow-up imaging.
- Limitations in detecting subtle changes or residual aneurysm components may exist with conventional angiography.
Purpose of the Study:
- To evaluate the advantages of 3D volume-rendering technique (VRT) in the follow-up digital subtraction (DS) angiography of coil-embolized intracranial aneurysms.
- To compare the sensitivity of 3D VRT with conventional 2D DS angiography and rotational angiography in detecting aneurysm remnants and parent artery stenosis.
Main Methods:
- A retrospective study included 109 patients with 121 intracranial aneurysms treated with endovascular coil embolization.
- Two neuroradiologists independently reviewed conventional 2D DS angiograms, rotational angiograms, and 3D VRT images from interventional procedures and follow-up sessions.
- Comparison of the three techniques focused on the detection of aneurysm remnants (neck and sac) and parent artery stenosis, with statistical analysis using Kruskal-Wallis and kappa tests.
Main Results:
- 3D VRT demonstrated statistically significant superiority over 2D DS angiography and rotational angiography in detecting aneurysm remnants (p=0.0028 and p=0.0257, respectively).
- No significant difference was found between rotational angiography and 2D DS angiography for remnant detection (p=0.4523).
- All three techniques showed no statistical significance in detecting parent artery stenosis (p=0.2842), although 3D VRT excluded one case of stenosis identified by the other methods.
Conclusions:
- 3D VRT is more sensitive than 2D DS angiography and rotational angiography for detecting aneurysm remnants after coil embolization.
- 3D VRT is a valuable tool for identifying parent artery stenosis.
- The authors recommend 3D VRT for routine angiographic follow-up of patients with coil-embolized intracranial aneurysms.
Object:
The authors conducted a study to evaluate the advantages of a 3D volume-rendering technique (VRT) in follow-up digital subtraction (DS) angiography of coil-embolized intracranial aneurysms.
Methods:
One hundred nine patients with 121 intracranial aneurysms underwent endovascular coil embolization and at least 1 follow-up DS angiography session at the authors' institution. Two neuroradiologists independently evaluated the conventional 2D DS angiograms, rotational angiograms, and 3D VRT images obtained at the interventional procedures and DS angiography follow-up. If multiple follow-up sessions were performed, the final follow-up was mainly considered. The authors compared the 3 techniques for their ability to detect aneurysm remnants (including aneurysm neck and sac remnants) and parent artery stenosis based on the angiographic follow-up. The Kruskal-Wallis test was used for group comparisons, and the kappa test was used to measure interobserver agreement. Statistical analyses were performed using commercially available software.
Results:
There was a high statistical significance among 2D DS angiography, rotational angiography, and 3D VRT results (X(2) = 9.9613, p = 0.0069) when detecting an aneurysm remnant. Further comparisons disclosed a statistical significance between 3D VRT and rotational angiography (X(2) = 4.9754, p = 0.0257); a high statistical significance between 3D VRT and 2D DS angiography (X(2) = 8.9169, p = 0.0028); and no significant difference between rotational angiography and 2D DS angiography (X(2) = 0.5648, p = 0.4523). There was no statistical significance among the 3 techniques when detecting parent artery stenosis (X(2) = 2.5164, p = 0.2842). One case, in which parent artery stenosis was diagnosed by 2D DS angiography and rotational angiography, was excluded by 3D VRT following observations of multiple views. The kappa test showed good agreement between the 2 observers.
Conclusions:
The 3D VRT is more sensitive in detecting aneurysm remnants than 2D DS angiography and rotational angiography and is helpful for identifying parent artery stenosis. The authors recommend this technique for the angiographic follow-up of patients with coil-embolized aneurysms.
More Related Videos
06:59Improved Registration of 3D CT Angiography with X-ray Fluoroscopy for Image Fusion During Transcatheter Aortic Valve Implantation
Published on: June 3, 2018
09:32Time-Resolved, Dynamic Computed Tomography Angiography for Characterization of Aortic Endoleaks and Treatment Guidance via 2D-3D Fusion-Imaging
Published on: December 9, 2021