Temporal averaging angiographic reconstructions from whole-brain CT perfusion for the detection of vasospasm - 20/04/23
, Marc Lenfant a, Pierre Thouant a, Karim Haioun b, Anthony Thay c, Frédéric Ricolfi a, Pierre-Olivier Comby aAbstract |
Purpose |
The aim of this study is to evaluate the image quality and diagnostic performance of angiographic images reconstructed from whole-brain CT perfusion (CTP) using temporal averaging compared to CT angiography (CTA) for the detection of vasospasm.
Materials and methods |
39 CT studies in 28 consecutive patients who underwent brain CTA with CTP for suspected vasospasm between September 2020 and May 2021 were retrospectively evaluated. The image quality of these two vascular imaging techniques was assessed either quantitatively (image noise, vascular enhancement, signal-to-noise (SNR) and contrast-to-noise (CNR) ratios,) and qualitatively (4 criteria assessed on a 5-point scale).
Intra and interobserver agreements and a diagnostic confidence score on the diagnosis of vasospasm were measured. Radiation dose parameters (volume CT dose index (CTDIvol) and dose-length product (DLP)) were recorded.
Results |
Both SNR and CNR were significantly higher with temporal averaging compared to CTA, increasing by 104% and 113%, respectively (p<0.001).
The qualitative assessment found no significant difference in overall image quality between temporal averaging (4.33 ± 0.48) and brain CTA (4.19 ± 0.52) (p = 0.12).There was a significant improvement in intravascular noise and arterial contrast enhancement with temporal averaging.
The evaluation of intra and interobserver agreements showed a robust concordance in the diagnosis of vasospasm between the two techniques.
Conclusions |
Temporal averaging appeared as a feasible and reliable imaging technique for the detection of vasospasm. The use of temporal averaging, replacing brain CTA, could represent a new strategy of radiation and contrast material doses reduction in these patients.
Le texte complet de cet article est disponible en PDF.Graphical abstract |
Highlights |
• | Patients hospitalized for aneurysmal subarachnoid hemorrhage frequently receive a high cumulative radiation dose. |
• | Temporal averaging reconstruction technique from brain CT perfusion appeared as an effective vascular imaging technique for the vasospasm assessment. |
• | The use of temporal averaging instead of brain CTA could represent a new strategy of contrast agent and radiation dose reduction in patients with suspected vasospasm following subarachnoid hemorrhage. |
Keywords : Brain computed tomography perfusion, Computed tomography angiography, Subarachnoid hemorrhage, Vasospasm, Temporal averaging, Image reconstruction
Abbreviation : CNR, CTA, CTDIvol, CTP, DLP, DLR, DSA, SAH, SNR
Plan
Vol 50 - N° 3
P. 333-340 - mai 2023 Retour au numéro
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