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66th Annual Meeting of the German Society of Neurosurgery (DGNC)
Friendship Meeting with the Italian Society of Neurosurgery (SINch)

German Society of Neurosurgery (DGNC)

7 - 10 June 2015, Karlsruhe

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Evaluation of a metal artifact reduction algorithm for flat panel detector CT-angiography in patients after surgical or endovascular treatment of intracranial aneurysms

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  • Rastislav Pjontek - Klinik für Diagnostische und Interventionelle Neuroradiologie, Universitätsklinikum der RWTH Aachen
  • Belgin Önenköprülü - Klinik für Diagnostische und Interventionelle Neuroradiologie, Universitätsklinikum der RWTH Aachen
  • Nicholas Hänsel - Klinik für Diagnostische und Interventionelle Neuroradiologie, Universitätsklinikum der RWTH Aachen
  • Yiannis Kyriakou - Siemens AG Healthcare Sector, Forchheim
  • Bernhard Scholz - Siemens AG Healthcare Sector, Forchheim
  • Gerrit Schubert - Klinik für Neurochirurgie, Universitätsklinikum der RWTH Aachen
  • Omid Nikoubashman - Klinik für Diagnostische und Interventionelle Neuroradiologie, Universitätsklinikum der RWTH Aachen
  • Ahmed Othman - Klinik für Diagnostische und Interventionelle Neuroradiologie, Universitätsklinikum der RWTH Aachen
  • Martin Wiesmann - Klinik für Diagnostische und Interventionelle Neuroradiologie, Universitätsklinikum der RWTH Aachen
  • Marc A. Brockmann - Klinik für Diagnostische und Interventionelle Neuroradiologie, Universitätsklinikum der RWTH Aachen

Deutsche Gesellschaft für Neurochirurgie. 66. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC). Karlsruhe, 07.-10.06.2015. Düsseldorf: German Medical Science GMS Publishing House; 2015. DocP 140

doi: 10.3205/15dgnc538, urn:nbn:de:0183-15dgnc5385

Published: June 2, 2015

© 2015 Pjontek et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.

Outline

Text

Objective: Flat panel detector angiographic computed tomography with intravenous contrast agent injection (ivACT) allows high-resolution imaging of cerebro-vascular structures. Metal artifacts caused by metallic implants like clips or coils lead to relevant degradation of image quality and are considered a significant problem. The aim of our study was to evaluate the influence of a novel metal artifact reduction (MAR) algorithm upon image quality in patients with surgically or endovascuarly treated intracranial aneurysms.

Method: Flat panel detector CT after intravenous application of 80 ml contrast agent was performed with an angiography system (Artis Zee; Siemens, Forchheim) using the 20s-DRH rotation protocol. The data from 24 patients with a total of 32 implants (coils, clips, stents) before and after MAR were independently evaluated by two blinded neuroradiologists.

Results: MAR improved the assessability of the brain parenchyma and small vessels (diameter <1 mm) in the neighborhood of metal implants as well as in a distance of 6 cm (p<0.001 each, Wilcoxon test). Furthermore, MAR significantly increased the assessability of parent vessel patency and potential aneurysm remnants (p<0.001 each, McNemar test). However, MAR did not improve assessability of stented vessels.

Conclusions: Using an intravenous contrast protocol, MAR significantly improves the assessability of brain parenchyma and vessels in patients with intracranial clips or coils.