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[Evaluation of three-dimensional CT angiography (3D-CTA) for the diagnosis of cerebral vasospasm]
R Takagi1, H Hayashi, H Kobayashi
1Department of Radiology, Nippon Medical School.
Insights
Three-dimensional CT angiography (3D-CTA) effectively diagnoses cerebral vasospasm after subarachnoid hemorrhage (SAH). This minimally invasive imaging technique shows significant vasospastic changes, aiding in timely patient assessment.
Area of Science:
- Neurology
- Radiology
- Medical Imaging
Background:
- Subarachnoid hemorrhage (SAH) can lead to delayed cerebral vasospasm, a critical complication.
- Accurate and timely diagnosis of cerebral vasospasm is essential for effective management and improved patient outcomes.
Purpose of the Study:
- To evaluate the diagnostic utility of three-dimensional CT angiography (3D-CTA) for cerebral vasospasm following SAH.
- To assess the minimally invasive nature and effectiveness of 3D-CTA in identifying vasospastic changes.
Main Methods:
- Eleven patients with suspected cerebral vasospasm post-SAH underwent 3D-CTA using a spiral CT scanner and intravenous contrast.
- Conventional angiography was performed in a subset of patients for comparison.
- Follow-up 3D-CTA was conducted one week later in eight patients.
Main Results:
- 3D-CTA successfully identified vasospastic changes in the cerebral vessels of eight out of eleven patients.
- Conventional angiography confirmed the presence of cerebral vasospasm in patients where it was performed.
- Follow-up 3D-CTA demonstrated resolution of vasospastic changes in eight patients after one week.
Conclusions:
- Three-dimensional CT angiography is a valuable and promising tool for assessing cerebral vasospasm after subarachnoid hemorrhage.
- The minimally invasive nature of 3D-CTA makes it a suitable alternative to conventional angiography for evaluating this condition.
Abstract:
We evaluated the usefulness of three-dimensional CT angiography (3D-CTA) for the diagnosis of cerebral vasospasm following subarachnoid hemorrhage (SAH). Eleven patients with SAH who were suspected of having cerebral vasospasm on the basis of their clinical symptoms were examined by 3D-CTA with a spiral CT scanner after an intravenous bolus administration of contrast medium. 3D-CTA revealed vasospastic changes of the cerebral vessels in eight patients. Conventional angiography was performed in six patients immediately after the 3D-CTA examination, and demonstrated the cerebral vasospasm. In eight patients, a second 3D-CTA was performed with the same technique one week after the first 3D-CTA examination. The second 3D-CTA showed the cerebral vessels without vasospastic change. In conclusion, 3D-CTA is a promising, minimally invasive strategy for the assessment of cerebral vasospasm.