Fusion 3-Dimensional Angiography of Both Internal Carotid Arteries in the Evaluation of Anterior Communicating Artery Aneurysms

• Published in: World neurosurgery Vol. 98; pp. 484 - 491
• Main Authors: Yang, Kuhyun, Koo, Hae-Won, Park, Wonhyoung, Kim, Jin Su, Choi, Choong Gon, Park, Jung Cheol, Ahn, Jae Sung, Kwon, Do Hoon, Kwun, Byung Duk, Lee, Deok Hee
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.02.2017
• Subjects: 3-Dimensional image; Adult; Aged; Aneurysm, Ruptured - pathology; Anterior communicating artery; Carotid Artery Diseases - pathology; Carotid Artery, Internal - pathology; Cerebral angiography; Cerebral Angiography - methods; Computed Tomography Angiography - methods; Diagnostic Errors; Female; Humans; Imaging, Three-Dimensional; Intracranial aneurysm; Intracranial Aneurysm - pathology; Magnetic Resonance Angiography - methods; Male; Middle Aged; 3D; CTA; Intracranial aneurysm; ICA; 3-Dimensional image; TFCA; ACoA; MRA; Cerebral angiography; Anterior communicating artery; ACA
• ISSN: 1878-8750; 1878-8769
• DOI: 10.1016/j.wneu.2016.11.047

To determine whether fusion 3-dimensional (3D) angiography of both internal carotid arteries can better disclose vascular details in patients diagnosed with anterior communicating artery (ACoA) aneurysms by computed tomography angiography (CTA) or magnetic resonance angiography (MRA). Thirty-eight patients diagnosed with ACoA aneurysms by CTA or MRA were evaluated by the new postprocessing feature, fusion 3D angiography, with results individually interpreted by 4 experts. Those experts compared fusion 3D angiography with dominant A1 side single 3D angiography to define advantages and disadvantages for ACoA aneurysms. Patients with unilateral A1 aplasia or rudimentary A1 were excluded. Patients who showed any disadvantages with this additional feature were classified as group 1, those with no advantages were classified as group 2, those with 1 or 2 advantages were classified as group 3, and those with 3 or more advantages were classified as group 4. Radiologic and clinical results were also evaluated. Of the 38 patients, 33 (87%) benefited from fusion 3D angiography, including 17 in group 3 and 16 in group 4; of the remaining patients, 1 was classified as group 1 and 4 were classified as group 2. Representative 5 categories of advantage to fusion angiography were found and summarized by the 4 experts. All 33 patients showed defining the exact anatomy of the ACoA, and 22 (67%) showed full angiographic features of A2 or A3, including branches. Fusion 3D angiography can significantly contribute to a better understanding of the complex anatomy of the anterior cerebral artery–ACoA complex, which is essential for successful treatment planning for ACoA aneurysms.