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1、.Currentusageofthree-dimensionalcomputedtomographyangiographyforthediagnosisandtreatmentofrupturedcerebralaneurysmsKenichiAmagasakiMD,NobuyasuTakeuchiMD,TakashiSatoMD,ToshiyukiKakizawaMD,TsuneoShimizuMDKantoNeurosurgicalHospital,Kumagaya,Saitama,JapanSummaryOurprevi

2、ousstudysuggestedthat3D-CTangiographycouldreplacedigitalsubtraction(DS)angiographyinmostcasesofrupturedcerebralaneurysms,especiallyintheanteriorcirculation.Thisstudyreviewedourfurtherexperience.Onehundredandfiftypatientswithrupturedcerebralaneurysmsweretreatedbetwee

3、nNovember1998andMarch2002.Only3D-CTangiographywasusedforthepreoperativework-upstudyinpatientswithanteriorcirculationaneurysms,unlesstheattendingneurosurgeonsagreedthatDSangiographywasrequired.Both3D-CTangiographyandDSangiographywereperformedinpatientswithposteriorci

4、rculationaneurysms,exceptforrecentcasesthatwerepossiblytreatedwith3D-CTangiographyalone.Onehundredsixteen(84%)of138patientswithrupturedanteriorcirculationaneurysmsunderwentsurgicaltreatment,butadditionalDSangiographywasrequiredin22cases(16%)..Onlytworecentpatientswe

5、retreatedsurgicallywith3D-CTangiographyalonein12patientswithposteriorcirculationaneurysms.Mostpatientswithrupturedanteriorcirculationaneurysmscouldbetreatedsuccessfullyafter3D-CTangiographyalone.However,additionalDSangiographyisstillnecessaryinatypicalcases.3D-CTang

6、iographymaybelimitedtocomplementaryuseinpatientswithrupturedposteriorcirculationaneurysms.a2003ElsevierLtd.Allrightsreserved.Keywords:3D-CTangiography,cerebralaneurysm,subarachnoidhaemorrhage,surgeryINTRODUCTIONRecently,three-dimensionalcomputedtomography(3D-CT)angi

7、ographyhasbecomeoneofthemajortoolsfortheidentificationofcerebralaneurysmsbecauseitisfaster,lessinvasive,andmoreconvenientthancerebralangiography.1–7Patientswithrupturedaneurysmscouldbetreatedunderdiagnosesbasedononly3D-CTangiography.5;63D-CTangiographyhassomelimitat

8、ionsforthepreoperativework-upforrupturedcerebralaneurysms,soadditionaldigitalsubtraction(DS)angiographyisstillnecessary,especiallyforaneur