The Use of HU Thresholding in Carotid-Cerebral CT Angiography: A Qualitative Study
Abstract
Background: CT scans with contrast media administration have been used to confirm the presence of pathology in the blood vessel of the brain. High accuracy and fast scanning time produced by CT scans make this modality the main choice in assessing aneurysm pathology in the brain. Technological advances and the development of CT-helical image acquisition techniques have enabled neuroradiologists to evaluate brain aneurysms in a short time. Magnetic resonance (MR) angiography has also been reported to be useful in the diagnosis of brain aneurysms, but it is generally more time-consuming than 3D CTA, and MRI is very sensitive to movement artifacts.
Methods: This research is qualitative research with an observational approach that aims to determine the management of carotid-cerebral CTA artery examination in Premier Bintaro Hospital. Unstructured interviews and documentation are used as study instruments to complete the required data.
Results: Cerebral Angiography CT examination technique in Premier Bintaro Hospital uses a bolus tracking scanning technique with ROI monitoring of the Carotid Internal Artery and using triggering of 100-120 HU as a peak enhancement to ROI monitoring. This has been proven to produce optimal enhancement in the Circulus of Willis (CoW) region as Volume of Investigation (VOI) in cerebral Angiography CT-Scan. Post-processing is done by displaying images ranging from axial pre-contrast, axial post-contrast, study (pathology), MIP (Axial, coronal, sagittal), Region of Interest MIP (structure labeling), 3D VRT-bone removal.
Conclusion: Scanning technique with bolus tracking and ROI monitoring of the Internal Carotid Artery and using triggering of 100-120 HU as a peak enhancement on ROI monitoring can display the arterial artery image very well so that it can be post-processed easily without reducing quality and related image information.Keywords
Full Text:
PDFReferences
Mack PF. Cerebral aneurysm. Yao Artusio’s Anesthesiol Probl Patient Manag Seventh Ed. 2012;552–75.
Marco R. Pathogenesis, Diagnosis, and Treatment of the Cerebral Aneurysm. J Neurol Neurophysiol [Internet]. 2021;12(8):550. Available from: https://www.iomcworld.org/open-access/pathogenesis-diagnosis-and-treatment-of-the-cerebral-aneurysm-83456.html%0Ahttps://www.iomcworld.org/abstract/pathogenesis-diagnosis-and-treatment-of-the-cerebral-aneurysm-83456.html
Vega J. What Is a Brain Aneurysm? [Internet]. 2021. p. 7. Available from: www.verywellhealth.com
Etminan N, Rinkel GJE. Cerebral aneurysms: Cerebral aneurysm guidelines-more guidance needed. Nat Rev Neurol [Internet]. 2015;11(9):490–1. Available from: http://dx.doi.org/10.1038/nrneurol.2015.146
Hacein-Bey L, Provenzale JM. Current imaging assessment and treatment of intracranial aneurysms. Am J Roentgenol. 2011;196(1):32–44.
Mallouhi A, Felber S, Chemelli A, Dessl A, Auer A, Schocke M, et al. Detection and characterization of intracranial aneurysms with MR angiography: Comparison of volume-rendering and maximum-intensity-projection algorithms. Am J Roentgenol. 2003;180(1):55–64.
de Figueiredo GN, Ertl-Wagner B. MDCT in neurovascular imaging. Med Radiol. 2019;185–205.
Toth G, Cerejo R. Intracranial aneurysms: Review of current science and management. Vasc Med (United Kingdom). 2018;23(3):276–88.
Maupu C, Lebas H, Boulaftali Y. Imaging Modalities for Intracranial Aneurysm: More Than Meets the Eye. Front Cardiovasc Med. 2022;9(February):1–9.
Shin JH, Lee HK, Choi CG, Suh DC, Lim TH, Kang W. The Quality of Reconstructed 3D Images in Multidetector-Row Helical CT: Experimental Study Involving Scan Parameters. Korean J Radiol. 2002;3(1):49–56.
Azhari S, Nayeb Aghaei H, Ghanaati H, Firouznia K, Zandi S. The diagnostic value of CT angiography in the diagnosis of residual aneurysm after brain aneurysm surgery. Iran J Radiol. 2018;15(1).
Paula B. Imaging of the Brain After Aneurysmal Subarachnoid Hemorrhage. 2010.
Cao X, Zeng Y, Wang J, Cao Y, Wu Y, Xia W. Differentiation of Cerebral Dissecting Aneurysm from Hemorrhagic Saccular Aneurysm by Machine-Learning Based on Vessel Wall MRI: A Multicenter Study. J Clin Med. 2022;11(13).
Samaniego EA, Roa JA, Hasan D. Vessel wall imaging in intracranial aneurysms. J Neurointerv Surg. 2019;11(11):1105–12.
Howard BM, Hu R, Barrow JW, Barrow DL. A comprehensive review of imaging of intracranial aneurysms and angiographically negative subarachnoid hemorrhage. Neurosurg Focus. 2019;47(6):1–13.
Paramount. Computed Tomography ( CT ) and Computed Tomography Angiography ( CTA ) Scans. 2021.
Prokop M, Michael G. Spiral and Multislice Computed Tomography of the Body . Stuttgart: Thieme; 2011.
Flohr TG, Schaller S, Stierstorfer K, Bruder H, Ohnesorge BM, Schoepf UJ. Multi-detector row CT systems and image-reconstruction techniques. Radiology. 2005;235(3):756–73.
Bruening R, Kuettner A, Flohr T. Protocols for multislice CT. Protocols for Multislice CT. 2006. 1–293 p.
Elnour H, Ahmed Hassan H, Mustafa A, Osman H, Alamri S, Yasen A. Assessment of Image Quality Parameters for Computed Tomography in Sudan. Open J Radiol. 2017;07(01):75–84.
Park S, Jang M, Lee K, Choi H, Lee Y, Park I, et al. Optimal placement of the region of interest for bolus tracking on brain computed tomography angiography in beagle dogs. J Vet Med Sci. 2021;83(8):1196–201.
Huang RY, Chai BB, Lee TC. Effect of region-of-interest placement in bolus tracking cerebral computed tomography angiography. Neuroradiology. 2013;55(10):1183–8.
Giffin NJ, Goadsby PJ. Basilar artery aneurysm with autonomic features: An interesting pathophysiological problem. J Neurol Neurosurg Psychiatry. 2001;71(6):805–8.
Karamessini MT, Kagadis GC, Petsas T, Karnabatidis D, Konstantinou D, Sakellaropoulos GC, et al. CT angiography with three-dimensional techniques for the early diagnosis of intracranial aneurysms. Comparison with intra-arterial DSA and the surgical findings. Eur J Radiol. 2004;49(3):212–23.
Vereniging KB, Universitair S, Antwerpen Z, Mulkens T, Hart H, Lier Z, et al. CT angiography : Basic principles and post- processing applications PROCEEDINGS OF THE VASCULAR IMAGING SYMPOSIUM VISA-2003 ,. 2003;(May 2016).
Yoon NK, McNally S, Taussky P, Park MS. Imaging of cerebral aneurysms: a clinical perspective. Neurovascular Imaging [Internet]. 2016;2(1):1–7. Available from: http://dx.doi.org/10.1186/s40809-016-0016-3
DOI: https://doi.org/10.31983/jahmt.v5i2.9575
Article Metrics
Refbacks
- There are currently no refbacks.
St. Tirto Agung, Pedalangan, Banyumanik, Semarang City, Central Java, Indonesia, Postal code 50268 Telp./Fax: (024)76479189