Fukushima J. Med. Sci.
Vol. 48, No. 2, 2002

［Regular Papers］

ACUTE ANEURYSM SURGERY USING THREE-DIMENSIONAL
CT ANGIOGRPHY WITHOUT CONVENTIONAL
CATHETER ANGIOGRAPHY

MASATO MATSUMOTO¹⁾, YUJI ENDO¹⁾, MASANORI SATO¹⁾,
SONOMI SATO¹⁾, JUN SAKUMA¹⁾, YUTAKA KONNO¹⁾,
KYOUICHI SUZUKI¹⁾, TATSUYA SASAKI¹⁾, NAMIO KODAMA¹⁾,
KENJI SUZUKI²⁾, TOSHIHIKO KATAKURA²⁾ and FUMIO SHISHIDO²⁾

¹⁾Department of Neurosurgery, Fukushima Medical University School of Medicine, Fukushima
²⁾Department of Radiology, Fukushima Medical University School of Medicine, Fukushima

(Received May 16, 2002, accepted May 27, 2002)

Abstract: The object of this study is to assess whether aneurysm surgery can be performed in patients with ruptured cerebral aneurysms by using three-dimensional computerized tomography angiography (3D-CTA) alone, without conventional catheter angiography (CCA).
    Between May 1994 and November 1996, a consecutive series of 60 cases of ruptured cerebral aneurysms was evaluated by both 3D-CTA and CCA prospectively and compared the detectability of cerebral aneurysms. Both 3D-CTA and CCA demonstrated a 100% diagnostic accuracy of ruptured cerebral aneurysms. In the associated unruptured cerebral aneurysms, the diagnostic accuracies of 3D-CTA and CCA were 96% and 92%, respectively. Based on the results, we have operated on 128 consecutive patients with ruptured aneurysms in the acute stage based on 3D-CTA findings since December 1996. One hundred twenty eight ruptured aneurysms including 50 associated unruptured aneurysms were detected by 3D-CTA. In seven of 128 ruptured aneurysms, which included four dissecting vertebral artery aneurysms, two basilar artery (BA) tip aneurysms, and one BA-superior cerebellar artery (SCA) aneurysm, 3D-CTA was followed by CCA to obtain diagnostic confirmation or information concerning the vein of Labbé, which was needed to guide the surgical approach for BA tip aneurysms. All of the ruptured aneurysms were confirmed at surgery and treated successfully. One hundred twenty one patients who underwent surgery with 3D-CTA findings only had no complications related to the lack of information of CCA.
    The authors considered that 3D-CTA could replace CCA in the diagnosis of ruptured aneurysms and that surgery could be performed in almost all acutely ruptured aneurysms by using only 3D-CTA without CCA.

Key words: 3D-CTA, cerebral aneurysm, operation, subarachnoid hemorrhage, helical CT

松本正人，遠藤雄司，佐藤正憲，佐藤園美，佐久間潤，紺野 豊，鈴木恭一，佐々木達也，児玉南海雄，鈴木健二，片倉俊彦，宍戸文男

Reprint requests to: Masato Matsumoto, Department of Neurosurgery, Fukushima Medical University School of Medicine, Fukushima City 960-1295, Japan.