Wie exakt sind die Größenbestimmungen von intrakraniellen Aneurysmen? -Eine multimodale Phantomstudie-

How to size intracranial aneurysms ? -a phantom study-

by Thilo Khakzad
Doctoral thesis
Date of Examination:2020-07-14
Date of issue:2020-07-07
Advisor:PD Dr. Marios-Nikos Psychogios
Referee:PD Dr. Marios-Nikos Psychogios
Referee:Prof. Dr. Dorothee Mielke
Persistent Address: http://dx.doi.org/10.53846/goediss-8075

 

 

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Abstract

English

Background and Purpose: The endovascular treatment of intracranial aneurysms has changed significantly in recent decades. Several new devices such as intrasacular flow diverters have expanded the range of treatments, but require very precise dimensioning of the aneurysm. In this study, we examined multi-detector and flat-screen angiography CT and digital subtraction imaging, as well as various post-processing methods (multiplanar reconstruction, volume rendering technology, 3D-DSA and conventional 2D angiography) for their ability to use size 2 Aneurysm models must be dimensioned precisely. Material and methods: Two aneurysm models with known aneurysm sizes were placed in a human skull. After iodine contrast media was injected, imaging was performed using a 128-slice CT scanner or an Artis Q double-decker angiosuite. Aneurysms were measured for width, neck, and height, and the mean difference from the known sizes was calculated for each technique. The technique with the most accurate measurement was defined as the criterion standard. We created Bland-Altman diagrams comparing all techniques against the criteria standard. Results: Angiograms adjusted according to a previous 3D run with a short distance between the object and the detector gave the most accurate aneurysm measurement: -0.07 ± 0.61 mm for aneurysm 1 and 0.17 ± 0, 39 mm for aneurysm 2. The measurements from conventional DSA images were similar and CT-based images were significantly inferior to the criteria standard. Conclusions: 2D-DSA with a short distance between lens and detector, which was set according to a previous 3D run, led to the most accurate aneurysm measurement and should therefore be performed before all endovascular aneurysm treatments.
Keywords: aneurysm + subarachnoidal bleeding + radiology
Schlagwörter: Aneurysma + Subarachnoidalblutung + Radiologie
 
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