• Journal of Korean Neurosurgical Society
• /
• 제30권6호
• /
• pp.711-716
• /
• 2001

Objectives : Three-dimensional computed tomographic angiography(3D-CTA) is recently developed diagnostic imaging modality. We have studied this noninvasive method for possible role in replacing conventional angiography( CA) in the detection of aneurysms of the circle of Willis in patients with subarachnoid hemorrahge(SAH). Methods : We studied retrospectively, the 100 patients with SAH or unruptured aneurysms admitted to our hospital from October 1997 to December 1998. Among there, 85 patients underwent CTA, 82 patients underwent CA and 67 patients underwent both of CTA and CA. 3D-CTA was obtained using maximum intensity projection(MIP) and shaded-surface display(SSD) reconstruction. Results : Total 107 aneurysms were detected in 92 patients, and 64 aneurysms were detected in 67 patients underwent both CTA and CA. In five cases of those 67 cases, aneurysms were detected by CA but not by 3D-CTA. The detection rate of aneurysms(91.8%) and the detection rate of parent artery in cases of anterior communicating artery aneurysms(86.9%) with total 3D-CTA were relatively compatible with that of CA. But 3D-CTA was not enough in detection of posterior communicating artery aneurysms, internal carotid artery aneurysms as well as small sized aneurysm(<3mm). Conclusion : We consider CTA is valuable in as a screening test for cerebral aneurysm and follow-up test. And it is also valuable in early surgery for patients with aneurysmal rebleeding because of simple, quick, non-invasive method.

• Journal of Korean Neurosurgical Society
• /
• 제39권6호
• /
• pp.427-431
• /
• 2006

Objective : The purpose of this study is to assess the usefulness of three-dimensional computed tomography angiography [3D-CTA] as a postoperative follow-up examination after intracranial aneurysms have been clipped. Methods : Between January 2002 and June 2005, 522 consecutive patients received treatment for intracranial aneurysms. A retrospective analysis of 310 patients with postoperative 3D-CTAs was performed to evaluate aneurysmal remnants and de novo aneurysms. This study was conducted in 271 patients with at least immediate and 6-month routine 3D-CT As for postoperative clipped aneurysm and 39 patients with 3D-CTAs for clipped aneurysm before 2002 when there was no 3D-CTA in our hospital. Results : Eight patients had abnormal CT angiographic findings. Aneurysm remnants were revealed in 4 patients and de novo aneurysms were discovered in 5 patients. Two patients were found at the postoperative 6-month 3D-CTA performed routinely. In 1 patient, the aneurysm was demonstrated on the way to the examination of syncope. In 2 patients, the author recommended 3D-CTA although there was no symptom because the patients had visited our institute long time ago [5.1, 4.5 years]. Of the 8 patients, 2 remnants and 1 de novo aneurysm were treated by endovascular treatment. Three de novo aneurysms at the middle cerebral artery and 1 pericallosal artery aneurysm were treated by direct clipping because these aneurysms were not suitable for the endovascular treatment in point of anatomical configuration. One patient with both remnant and de novo aneurysm was treated conservatively. Conclusion : 3D-CTA is an available, non-invasive diagnostic tool for the postoperative follow-up examination of aneurysmal state in patients after clipping.

• 대한전자공학회:학술대회논문집
• /
• 대한전자공학회 2003년도 하계종합학술대회 논문집 V
• /
• pp.2697-2700
• /
• 2003

이 논문에서는 3 차원 CT/CTA 영상 데이터에 대하여 고속 자동 정합 기법을 제안한다. 제안하는 기법은 다해상도 (multi-resolution) 구조의 정규 상호 정보량(normalized mutual information) 을 최대화하는 정합 방식에서, 정합 유사도를 계산하는 볼륨 영역을 효율적으로 줄여 정합 속도를 증가시키는 방법이다. 제안된 정합방식을 CT/CTA (CT angiography) 팬텀 데이터와 7 세트의 실제 CT/CTA 임상 데이터에 적용하여 테스트하였다. 이로부터 제안하는 방식이, 정합 정확도를 유지하는 동시에 정합 속도를 10 ∼ 60％ 로 감소시킴을 확인 할 수 있었다. 또한 제안된 정합 방식을 DS-CTA (digital subtraction CT angiography) 에 적용하여, CT/CTA 영상으로부터 혈관 영상을 성공적으로 추출하였다.

• 대한자기공명의과학회:학술대회논문집
• /
• 대한자기공명의과학회 2003년도 제8차 학술대회 초록집
• /
• pp.23-23
• /
• 2003

To evaluate clinical visualization of intracranial aneurysms between 3D-TOF MRA with 3.0T MR and CTA with 16-slices MDCT. In a prospective series, 12 patients with 16 aneurysms were studies with 3D-TOF MRA and CTA. MRA were performed on a GE Signa 3.0 T system (Signa VH/i, GE) with 25/3/20 (TR/TE/FA). CTA were peformed on a 16 slice MDCT (Sensation 16, Somatom, Siemens) with IV shooting of 80 ml iodinated contrast mediumat antecubital vein at a rate of 3.5 ml/sec. Four among 12 patients underwent DSA for surgery. Size, shape, neck and parent vessel of aneurysms were evaluated for comparison of visualization and detectability of aneurysms.

• Journal of International Society for Simulation Surgery
• /
• 제2권1호
• /
• pp.17-25
• /
• 2015

Purpose In this paper, we propose a robust 3D vessel tracking algorithm by utilizing an active contour model and unscented Kalman filter which are the two representative algorithms on segmentation and tracking. Materials and Methods The proposed algorithm firstly accepts user input to produce an initial estimate of vessel boundary segmentation. On each Computed Tomography Angiography (CTA) slice, the active contour is applied to segment the vessel boundary. After that, the estimation process of the unscented Kalman filter is applied to track the vessel boundary of the current slice to estimate the inter-slice vessel position translation and shape deformation. Finally both active contour and unscented Kalman filter are inter-operated for vessel segmentation of the next slice. Results The arbitrarily shaped blood vessel boundary on each slice is segmented by using the active contour model, and the Kalman filter is employed to track the translation and shape deformation between CTA slices. The proposed algorithm is applied to the 3D visualization of chest CTA images using graphics hardware. Conclusion Through this algorithm, more opportunities, giving quick and brief diagnosis, could be provided for the radiologist before detailed diagnosis using 2D CTA slices, Also, for the surgeon, the algorithm could be used for surgical planning, simulation, navigation and rehearsal, and is expected to be applied to highly valuable applications for more accurate 3D vessel tracking and rendering.

• 한국멀티미디어학회논문지
• /
• 제16권12호
• /
• pp.1454-1464
• /
• 2013

본 논문에서는 수술 중 촬영된 2D XA(X-ray Angiogram) 영상에 수술 전 촬영된 3D CTA (Computed Tomography Angiography) 영상 정보를 융합 가시화하기 위한 고속의 강체 정합 기법을 제안한다. 본 논문에서는 두 혈관 사이의 특징점 정보를 이용하여 예측 투영 위치 지점을 추정하는 삼각 측정을 통한 추정치 예측 기법을 제안하여 빠르고 견고한 초기 정합이 가능하다. 이에 더하여 주축을 생성하여 정렬시킨 후 경계 상자를 이용하여 혈관의 형태를 비교하는 방법으로 더욱 정확한 초기 정합이 가능하다. 다음으로 정밀정합은 선택적 거리 측정을 통하여 각 영상에서의 혈관들의 거리 차이가 최소인 위치로 영상을 정합한다. 실험으로 5명의 환자 데이터에 대하여 영상정합을 하였고, 기존 기법과 수행 속도와 정확성, 견고성 측면에서 비교 평가하였다. 실험 결과 제안 기법은 기존 기법에 비하여 최적의 위치로 빠르고 견고하게 정합되었다.

• Journal of Korean Neurosurgical Society
• /
• 제42권1호
• /
• pp.35-41
• /
• 2007

Objective : Determining the location of paraclinoid aneurysms for microsurgery is important for selecting treatment options, especially when deciding on the release of the dural ring in direct clipping. We examined the reliability of using the optic strut as an anatomical landmark for evaluating the location of paraclinoid aneurysms. Methods : Cadaveric dissection was performed to establish the relationship of the optic strut to the dural ring. Results from these anatomic studies were compared with the three-demensional computed tomographic angiographic [3D-CTA] findings of nine patients with ten paraclinoid aneurysms between May 2004 and October 2005. These, 3D-CTA results were then compared with intraoperative findings. Results : The inferior boundary of the optic strut accurately localized the point at the proximal dural ring in cadaveric study. The optic strut and its relationship to the aneurysms was well observed on the multiplanar reformats of 3D-CTA. During microsurgery, nine of ten aneurysms were verified to arise from distal to the upper surface of the optic strut. Two aneurysms that had arisen between the inferior and superior boundary of the optic strut were observed to lie within the carotid cave. One aneurysm which had arisen at the inferior boundary of the optic strut and directed inferiorly was observed to lie within the cavernous sinus just after the release of the proximal ring. Conclusion : The optic strut, as identified with multiplanar reformats of 3D-CTA, provided a reliable anatomic landmark for the proximal rings and an important information about the location of aneurysms around the anterior clinoid process (ACP). Therefore, 3D-CTA and the optic strut could become an invaluable tool and a landmark in the assessment of the location of paraclinoid aneurysms for microsurgery.

• Journal of Korean Neurosurgical Society
• /
• 제48권5호
• /
• pp.399-405
• /
• 2010

Objective : Patients with spontaneous intracerebral hemorrhage (ICH) presenting within 24 hours of symptom onset are known to be increased risk of hematoma expansion which is closely correlated with morbidity and mortality. We investigated whether tiny enhancing foci ('Spot sign') on axial view of 3-dimensional computed tomography angiography (3D-CTA) source images can predict subsequent hematoma expansion in spontaneous ICH. Methods : During a 2-year period (March 2007-March 2009), we prospectively evaluated 3D-CTA of 110 patients with spontaneous ICH. Based on source images of 3D-CTA, patients were classified according to presence or absence of 'Spot sign'; 'Spot sign' (+) group, 'Spot sign' (-) group. Radiological factors and clinical outcomes were compared between two groups. Results : Hematoma expansion occurred in 16 patients (15%). Mean Glasgow Coma Scale (GCS) score of patients with hematoma expansion was significantly different compared to score of patients without hematoma expansion (5 vs. 9, P < 0.001). Nineteen patients (16%) of 110 ICH patients demonstrated 'spot sign' on 3D-CTA. Among the 'spot sign' (+) group, 53% of patients developed hematoma expansion. Conversely 7% of patients without 'spot sign' demonstrated the hematoma expansion (p < 0.001). Initial volume and location of hematoma were significantly not associated with hematoma expansion except shape of hematoma. Conclusion : Our study showed that patients with hematoma expansion of spontaneous ICH had significant clinical deterioration. And the fact that 'spot sign' (+) group have higher risk of hematoma expansion suggests the presence of 'spot sign' on source images of 3D-CTA can give a clue to predict hematoma expansion in spontaneous ICH.

• 대한방사선기술학회지:방사선기술과학
• /
• 제46권1호
• /
• pp.9-14
• /
• 2023

When measuring cerebrovascular with 3D rotational angiography, the accuracy was verified by comparing the actual size and measurement size, respectively. It is intended to help select therapeutic materials and instruments during cerebrovascular intervention by comparing the average error rates for measured values in the 3DRA and CTA methods by examining with protocols such as brain CTA, which are always performed in emergency situations. The mean error rate between the groups of measurers was ±3.655% for radiation technologist and ±3.331% for university students, and the mean error rate of the student group was within tolerance (±10%), and the independent sample T-test result t =0.879, p=0.394 (p>0.05) showed no statistically difference between the two. In addition, the average error rate measured by both groups by 3DRA was measured below ±5% within the tolerance error rate (±10%), and most of CTA was measured within the tolerance range (±10%), but showed an average error rate of up to 5.65%, and the independent sample T-test result was statistically more accurate than 3DRA. Both the 3DRA method and the brain CTA method for measuring cerebrovascular size could be accurately measured within tolerance, but it would be better to measure cerebrovascular blood vessels using a more accurate 3DRA method during cerebrovascular intervention.

• Journal of Korean Neurosurgical Society
• /
• 제41권4호
• /
• pp.230-235
• /
• 2007

Objective : We investigated the incidence of the vascular abnormalities associated with spontaneous intracerebral hemorrhage [ICH] using three-dimensional computed tomographic angiography [3D-CTA]. Methods : We prospectively assessed consecutive 76 patients with spontaneous intracerebral hemorrhage [ICH] who underwent 3D-CTA between June 2003 and May 2005. The patients with a recent history of trauma or mainly subarachnoid hemorrhage were excluded. We investigated relationship between vascular abnormality and ICH location. The findings of 3D-CTA were classified as one of three patterns with ICH; type A [without evidence of vascular abnormality], type B [with no vascular abnormality as the source of hemorrhage, but with incidental vascular abnormality], and type C [presence of a vascular abnormality as the source of hemorrhage]. Results : Sites of ICH were lobar 26, basal ganglia 23, thalamus 17, posterior fossa 6 and dominant intraventricular hemorrhage [IVH] 4. Among 76 patients, sixteen [21.1%] vascular abnormalities were noted excluding 13 cases of stenoocclusive disease. Sixteen cases included 6 cases of cerebral aneurysms [7.9%], 5 moyamoya diseases [6.6%], 4 arteriovenous malformations [5.3%] and 1 dural sinus thrombosis [1.3%]. Lobar ICH [30.8%] had a higher vascular abnormalities than other types, and younger age [<40] group had a higher incidence of vascular abnormalities than old age group. The patterns of 3D-CTA include sixty cases [79.0%] of type A, 6 cases [7.8%] of type Band 10 cases [13.2%] of type C. The vascular abnormalities were found in 8 [13.5%] of 59 hypertensive patients and 8 [47.0%] of 17 non-hypertensive patients [p=0.006]. Conclusion : 3D-CT angiography is considered a useful screening tool for ICH patients with suspected cerebrovascular abnormalities and should be considered in such clinical settings, especially in lobar type and in non-hypertensive younger patients.