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Proximal Arterial Diameters on CT Angiography and Digital Subtraction Angiography Correlate Both at Admission and in the Vasospasm Period After Aneurysmal Subarachnoid Hemorrhage

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Neurovascular Events After Subarachnoid Hemorrhage

Part of the book series: Acta Neurochirurgica Supplement ((NEUROCHIRURGICA,volume 120))

Abstract

Background: Comparison of artery diameters between CT angiography (CTA) and subtraction arteriography (DSA) has the limitation that measurements on DSA are provided as relative units, making a quantitative comparison difficult. On CTA, artery diameters may depend on windowing settings and may lead to false measurements. This study assesses the correlation between CTA and DSA based on measurements in a basic imaging viewer using normalized DSA values, and assesses whether the validity is time dependent.

Methods: Patients with aneurysmal subarachnoid hemorrhage (aSAH) were included if they underwent both CTA and DSA within 24 h. The analysis was performed using the basic imaging application Centricity Enterprise PACS viewer (GE Healthcare). A total of 15 arterial locations were assessed on CTA and DSA and a specific measurement protocol with normalization of all artery diameters to the cavernous segment of the internal carotid artery was used. Pearson correlation analysis was calculated to access the correlation of normalized arterial diameters measured with both methods at admission and at clinical onset of CVS.

Results: A total of 627 arteries in 38 patients were analyzed in both CTA and DSA. There was a significant correlation coefficient (R = 0.706) of artery diameters between CTA and DSA measures (p < 0.0001). This correlation remained high when comparing CTA and DSA at admission (correlation coefficient: 0.641; p < 0.0001) vs. in the vasospasm period (0.835; p < 0.0001). The correlation was good in all proximal artery segments and lost significance only when distal vessel segments were considered.

Conclusion: Using basic imaging viewers, mostly accessible for clinicians, CTA is a noninvasive and reliable method to assess proximal arterial diameters of the brain in the management of cerebral vasospasm in the acute phase after aSAH. Significance is reached, independent of whether CTA is obtained in the acute phase or during the period of vasospasm, by normalization of basal cerebral artery diameters to a nonvariable anatomic landmark, i.e., the petrous or cavernous internal carotid artery diameter.

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Conflict of Interest Statement

We declare that we have no conflict of interest

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Authors and Affiliations

  1. Department of Neurosurgery, Kantonsspital Aarau, Aarau, Switzerland

    Hassen Kerkeni, Bawarjan Schatlo MD, Hiroki Dan-Ura MD, Javier Fandino MD & Ali-Reza Fathi MD

  2. Department of Neurosurgery, Kantonsspital Aarau, Tellstrasse 1, Aarau, 5001, Switzerland

    Carl Muroi MD

  3. Department of Intensive Care Medicine, University and University Hospital Bern, Bern, Switzerland

    Carl Muroi MD

  4. Department of Neuropharmacology, Faculty of Pharmaceutical Sciences, Fukuoka University, Fukuoka, Japan

    Carl Muroi MD

  5. Neurocritical Care Unit, Department of Neurosurgery, University Hospital Zurich, Zurich, Switzerland

    Carl Muroi MD

  6. Department of Neuroradiology, Kantonsspital Aarau, Tellstrasse, Aarau, 5001, Switzerland

    Luca Remonda MD & Michael Diepers

  7. Division of Neuroradiology, Department of Radiology, Kantonsspital Aarau, Aarau, Switzerland

    Luca Remonda MD & Michael Diepers

Authors
  1. Hassen Kerkeni
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  2. Bawarjan Schatlo MD
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  3. Hiroki Dan-Ura MD
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  4. Luca Remonda MD
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  5. Carl Muroi MD
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  6. Michael Diepers
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  7. Javier Fandino MD
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  8. Ali-Reza Fathi MD
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Corresponding author

Correspondence to Ali-Reza Fathi MD .

Editor information

Editors and Affiliations

  1. Department of Neurosurgery, Kantonsspital Aarau, Aarau, Switzerland

    Javier Fandino

  2. Department of Neurosurgery, Kantonsspital Aarau, Aarau, Switzerland

    Serge Marbacher

  3. Department of Neurosurgery, Kantonsspital Aarau, Aarau, Switzerland

    Ali-Reza Fathi

  4. Department of Neurosurgery, Kantonsspital Aarau, Aarau, Switzerland

    Carl Muroi

  5. Department of Neurosurgery Neurointensive Care Unit, University Hospital Zurich, Zurich, Switzerland

    Emanuela Keller

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Kerkeni, H. et al. (2015). Proximal Arterial Diameters on CT Angiography and Digital Subtraction Angiography Correlate Both at Admission and in the Vasospasm Period After Aneurysmal Subarachnoid Hemorrhage. In: Fandino, J., Marbacher, S., Fathi, AR., Muroi, C., Keller, E. (eds) Neurovascular Events After Subarachnoid Hemorrhage. Acta Neurochirurgica Supplement, vol 120. Springer, Cham. https://doi.org/10.1007/978-3-319-04981-6_29

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  • DOI: https://doi.org/10.1007/978-3-319-04981-6_29

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-04980-9

  • Online ISBN: 978-3-319-04981-6

  • eBook Packages: MedicineMedicine (R0)

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