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1、Currentusageofthree-dimensionalcomputedtomographyangiographyforthediagnosisandtreatmentofrupturedcerebralaneurysmsKenichiAmagasakiMD,NobuyasuTakeuchiMD,TakashiSatoMD,ToshiyukiKakizawaMD,TsuneoShimizuMDKantoNeurosurgicalHospital,Kumagaya,Saitama,JapanSummaryOurpreviousstudysuggestedtha
2、t3D-CTangiographycouldreplacedigitalsubtraction(DS)angiographyinmostcasesofrupturedcerebralaneurysms,especiallyintheanteriorcirculation.Thisstudyreviewedourfurtherexperience.OnehundredandfiftypatientswithrupturedcerebralaneurysmsweretreatedbetweenNovember1998andMarch2002.Only3D-CTangi
3、ographywasusedforthepreoperativework-upstudyinpatientswithanteriorcirculationaneurysms,unlesstheattendingneurosurgeonsagreedthatDSangiographywasrequired.Both3D-CTangiographyandDSangiographywereperformedinpatientswithposteriorcirculationaneurysms,exceptforrecentcasesthatwerepossiblytre
4、atedwith3D-CTangiographyalone.Onehundredsixteen(84%)of138patientswithrupturedanteriorcirculationaneurysmsunderwentsurgicaltreatment,butadditionalDSangiographywasrequiredin22cases(16%).Onlytworecentpatientsweretreatedsurgicallywith3D-CTangiographyalonein12patientswithposteriorcirculati
5、onaneurysms.Mostpatientswithrupturedanteriorcirculationaneurysmscouldbetreatedsuccessfullyafter3D-CTangiographyalone.However,additionalDSangiographyisstillnecessaryinatypicalcases.3D-CTangiographymaybelimitedtocomplementaryuseinpatientswithrupturedposteriorcirculationaneurysms.a2003El
6、sevierLtd.Allrightsreserved.Keywords:3D-CTangiography,cerebralaneurysm,subarachnoidhaemorrhage,surgeryINTRODUCTIONRecently,three-dimensionalcomputedtomography(3D-CT)angiographyhasbecomeoneofthemajortoolsfortheidentificationofcerebralaneurysmsbecauseitisfaster,lessinvasive,andmoreconve
7、nientthancerebralangiography.1–7Patientswithrupturedaneurysmscouldbetreatedunderdiagnosesbasedononly3D-CTangiography.5;63D-CTangiographyhassomelimitationsforthepreoperativework-upforrupturedcerebralaneurysms,soadditionaldigitalsubtraction(DS)angiographyisstillnecessary,especiallyforan
8、eurys