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1、Currentusageofthree-dimensionalcomputedtomographyangiographyforthediagnosisandtreatmentofrupturedcerebralaneurysmsKenichiAmagasakiMD,NobuyasuTakeuchiMD,TakashiSatoMD,ToshiyukiKakizawaMD,TsuneoShimizuMDKantoNeurosurgicalHospital,Kumagaya,Saitama,JapanSumma
2、ryOurpreviousstudysuggestedthat3D-CTangiographycouldreplacedigitalsubtraction(DS)angiographyinmostcasesofrupturedcerebralaneurysms,especiallyintheanteriorcirculation.Thisstudyreviewedourfurtherexperience.Onehundredandfiftypatientswithrupturedcerebralaneur
3、ysmsweretreatedbetweenNovember1998andMarch2002.Only3D-CTangiographywasusedforthepreoperativework-upstudyinpatientswithanteriorcirculationaneurysms,unlesstheattendingneurosurgeonsagreedthatDSangiographywasrequired.Both3D-CTangiographyandDSangiographywerepe
4、rformedinpatientswithposteriorcirculationaneurysms,exceptforrecentcasesthatwerepossiblytreatedwith3D-CTangiographyalone.Onehundredsixteen(84%)of138patientswithrupturedanteriorcirculationaneurysmsunderwentsurgicaltreatment,butadditionalDSangiographywasrequ
5、iredin22cases(16%)...Onlytworecentpatientsweretreatedsurgicallywith3D-CTangiographyalonein12patientswithposteriorcirculationaneurysms.Mostpatientswithrupturedanteriorcirculationaneurysmscouldbetreatedsuccessfullyafter3D-CTangiographyalone.However,addition
6、alDSangiographyisstillnecessaryinatypicalcases.3D-CTangiographymaybelimitedtocomplementaryuseinpatientswithrupturedposteriorcirculationaneurysms.a2003ElsevierLtd.Allrightsreserved.Keywords:3D-CTangiography,cerebralaneurysm,subarachnoidhaemorrhage,surgeryI
7、NTRODUCTIONRecently,three-dimensionalcomputedtomography(3D-CT)angiographyhasbecomeoneofthemajortoolsfortheidentificationofcerebralaneurysmsbecauseitisfaster,lessinvasive,andmoreconvenientthancerebralangiography.1–7Patientswithrupturedaneurysmscouldbetreat
8、edunderdiagnosesbasedononly3D-CTangiography.5;63D-CTangiographyhassomelimitationsforthepreoperativework-upforrupturedcerebralaneurysms,soadditionaldigitalsubtraction(DS)angiographyisstillnecessary,especiallyforaneur
