Head and Neck Dual Energy Bone Removal Computed Tomography Angiography Using the Intracranial Aneurysms

  Objective  To evaluate the diagnostic accuracy of dual energy bone removal CT angiography (DEBR CTA) in the detection of intracranial aneurysms, compared with the findings of digital subtraction angiography (DSA) and three-dimensional rotational digital subtraction angiography (3DRA).

  Methods  Eight patiens with suspected intracranial aneurysms underwent dual energy CTA, DSA, and 3DRA. The intracranial arteries were divided into 16 areas according to the locations of tumor-carrying arteries. Aneurysms detected with DEBR CTA was compared with DSA/3DRA findings on a per-patient and a per-aneurysm basis. Aneurysms were classified into four groups according to the maximun diameter, which included:not detected, less than 3 mm, 3-5 mm and more than 5 mm.

  Results  Nine aneurysms were detected by DEBR CTA in eight patients, and all of them were confirmed by DSA/3DRA. The maximum diameter of the aenrysms detected by DSA/3DRA and DEBR CTA was (5.2±5.1) mm and (5.7±5.6) mm, respectively (P > 0.05). Two distal blood-supply arteries of two aneurysms were not detected by DEBR CTA, which were shown by CTA without bone removal and DSA/3DRA. In the detection of aneurysms larger than 5 mm, DEBR CTA had an accuracy of 100%. One considered to be less than 3 mm in DEBR CTA was detected to be 3-5 mm in DSA/3DRA.

  Conclusions  DEBR CTA has a high diagnostic accuracy in the detection of intracranial aneurysms, and has shown good consistence with DSA/3DRA. However, DEBR CTA may miss small distal blood-supply arteries and underestimate the size of small aneurysms near the skull base.