Journal of Korean Neurosurgical Society

The Korean Neurosurgical Society (대한신경외과학회)
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Source Image Based New 3D Rotational Angiography for Differential Diagnosis between the Infundibulum and an Internal Carotid Artery Aneurysm : Pilot Study

  • Jang, Hyeongyu (Department of Neurosurgery, International St. Mary's Hospital, College of Medicine, Catholic Kwandong University) ;
  • Jung, Woo Sang (Department of Radiology, Ajou University Hospital, College of Medicine, Ajou University) ;
  • Myoung, Seong Uk (Department of Radiology, Bundang Jesaeng General Hospital) ;
  • Kim, Jung-Jae (Department of Neurosurgery, Ewha Womans University Seoul Hospital, College of Medicine, Ewha Womans University) ;
  • Jang, Chang Ki (Department of Neurosurgery, Yongin Severance Hospital, College of Medicine, Yonsei University) ;
  • Cho, Kwang-Chun (Department of Neurosurgery, International St. Mary's Hospital, College of Medicine, Catholic Kwandong University)
  • Received : 2020.12.02
  • Accepted : 2021.03.10
  • Published : 2021.09.01
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Abstract

Objective : Distinguishing between an infundibulum and a true aneurysm is clinically important. This study aimed to evaluate whether using source image based new three-dimensional rotational angiography (S-n3DRA) can increase the rate of aneurysm detection and improve distinction between a true aneurysm and an infundibulum. Methods : Twenty-two consecutive patients with 23 lesions, were evaluated by time-of-flight (TOF) magnetic resonance angiography (MRA), S-n3DRA, and digital subtraction angiography (DSA). The data were retrospectively and independently reviewed by two neurointerventionists, and the diagnoses based on TOF MRA, S-n3DRA, and DSA were compared. The diagnostic efficacy (interobserver agreement and diagnostic performance) of S-n3DRA was compared with that of TOF MRA. Results : S-n3DRA showed higher interobserver agreement (κ=0.923) than TOF MRA (κ=0.465) and significantly higher accuracy than MRA in distinguishing an aneurysm from an infundibulum (p=0.0039). Conclusion : Compared to MRA, S-n3DRA could provide better screening accuracy and information for distinguishing an aneurysm from an infundibulum. Therefore, S-n3DRA has the potential to reduce the need for DSA.

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References

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