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Giant intracranial aneurysms: rapid sequential computed tomography

R S Pinto, W A Cohen, I I Kricheff

    AJR. American Journal of Roentgenology
    |November 1, 1982
    PubMed
    Summary
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    Dynamic CT scans effectively differentiate giant intracranial aneurysms from other brain lesions by analyzing contrast medium transit times. This technique aids in accurate diagnosis and monitoring treatment effectiveness for these complex vascular conditions.

    Area of Science:

    • Neurology
    • Radiology
    • Medical Imaging

    Background:

    • Giant intracranial aneurysms commonly manifest as mass lesions, not subarachnoid hemorrhage.
    • Routine CT scans with contrast can detect these aneurysms but may lead to misdiagnosis, such as basal meningioma.
    • Accurate differentiation of intracranial aneurysms from other space-occupying lesions is crucial for appropriate patient management.

    Purpose of the Study:

    • To evaluate the efficacy of dynamic computed tomography (CT) in differentiating giant intracranial aneurysms from other intracranial lesions.
    • To assess the diagnostic value of contrast bolus transit-time analysis in identifying intracranial aneurysms.
    • To explore the utility of dynamic CT in post-treatment evaluation of aneurysms.

    Main Methods:

    • Utilized rapid sequential scanning (dynamic CT) with bolus injection of Renografin-76 (40 ml).

    Related Experiment Videos

  • Analyzed the transit-time dynamics of contrast medium passage through intracranial lesions in five patients.
  • Compared contrast dynamics in confirmed aneurysms with those in pituitary tumors, craniopharyngiomas, and meningiomas.

    • Main Results:

    • Dynamic CT successfully differentiated giant intracranial aneurysms from other lesions based on contrast transit-time analysis.
    • Observed distinct contrast bolus transit dynamics in aneurysms compared to pituitary tumors, craniopharyngiomas, and meningiomas.
    • Dynamic CT proved useful in assessing luminal patency or thrombosis after carotid artery ligation for aneurysm treatment.

    Conclusions:

    • Dynamic CT with contrast transit-time analysis provides a conclusive method for diagnosing giant intracranial aneurysms.
    • This technique offers a specific diagnostic tool, distinguishing aneurysms from common misdiagnoses like meningioma.
    • Dynamic CT serves as a valuable alternative to angiography for evaluating aneurysm treatment outcomes.