Abstract
The ability to perform neuroimaging on the angiography suite is important in making decisions during neurointerventions. Our aim was the evaluation of ACT as a fast available diagnostic tool during and after neuroendovascular procedures and the comparison of ACT with postinterventional MDCT. Eighty-four peri-interventional ACT acquisitions were obtained and evaluated: 38 after coil embolization of cerebral aneurysms, 16 after intracranial angioplasty with stent placement, and 30 after endovascular mechanical thrombectomy and lysis. Interventions and ACTs were performed on a biplane angiography system equipped with flat panel detectors. Postprocessing was performed on a dedicated workstation, and multiplanar reformations were generated. Reference studies were performed on a 16- or 128-section MDCT scanner. All studies were independently evaluated by 3 blinded neuroradiologists. The Wilcoxon test was applied for the statistical analysis. ACT and MDCT images were of equal diagnostic quality in most cases related to the supratentorial ventricular system and the detection of hemorrhages (subarachnoidal, intraparenchymal, and intraventricular). Regarding the supratentorial ventricular system, an adequate diagnostic quality was assigned to 94% of the ACT acquisitions. For the detection of hemorrhage, no statistically significant difference was noted between ACT and MDCT. However, for the infratentorial region, ACT performed relatively poorly compared with MDCT. The diagnostic evaluation of gray matter (basal ganglia, insular cortex, and central cortex) by ACT is not sufficient, with <20% of the acquisitions scoring a diagnostic value. After neuroendovascular procedures and within the angiography suite, ACT enables an immediate detection of peri-interventional hemorrhage or hydrocephalus. However, for the detection of cerebral infarction, ACT is not yet reliable.
Highlights
AND PURPOSE: The ability to perform neuroimaging on the angiography suite is important in making decisions during neurointerventions
ACT and MDCT images were of equal diagnostic quality in most cases related to the supratentorial ventricular system and the detection of hemorrhages
After neuroendovascular procedures and within the angiography suite, ACT enables an immediate detection of peri-interventional hemorrhage or hydrocephalus
Summary
Our aim was the evaluation of ACT as a fast available diagnostic tool during and after neuroendovascular procedures and the comparison of ACT with postinterventional MDCT. The purpose of our study was to evaluate the feasibility and diagnostic value of ACT in peri-interventional imaging and, in the detection and progress of hemorrhage or hydrocephalus. We aimed to evaluate the differentiation of gray and white matter, trying to observe if there is a capability to perform stroke imaging within the angiography suite
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