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PT  - JOURNAL ARTICLE
AU  - Brinjikji, W.
AU  - Cloft, H.
AU  - Lanzino, G.
AU  - Kallmes, D.F.
TI  - Comparison of 2D Digital Subtraction Angiography and 3D Rotational Angiography in the Evaluation of Dome-to-Neck Ratio
AID  - 10.3174/ajnr.A1444
DP  - 2009 Apr 01
TA  - American Journal of Neuroradiology
PG  - 831--834
VI  - 30
IP  - 4
4099  - http://www.ajnr.org/content/30/4/831.short
4100  - http://www.ajnr.org/content/30/4/831.full
SO  - Am. J. Neuroradiol.2009 Apr 01; 30
AB  - BACKGROUND AND PURPOSE: Dome-to-neck ratio of intracranial aneurysms is an important predictor of outcomes of endovascular coiling. 3D imaging techniques are increasingly used in evaluating the dome-to-neck ratio of aneurysms for intervention. The purpose of this study was to determine whether 3D rotational angiography (3DRA) can be used to determine accurately the dome-to-neck ratio of intracranial aneurysms when compared with conventional 2D digital subtraction angiography (2D DSA).MATERIALS AND METHODS: A retrospective analysis of 180 patients with 205 intracranial aneurysms who underwent both 2D DSA and 3DRA for evaluation of previously untreated aneurysms was conducted. Dome-to-neck ratios were compared between 2D DSA and 3DRA images. The mean difference in dome-to-neck ratios between 2D DSA and 3DRA was calculated. The proportions of “wide-neck” aneurysms seen on 2D DSA and 3DRA were compared by using 2 different definitions of “wide-neck,” including &amp;lt;1.5 and &amp;lt;2.0.RESULTS: The average dome-to-neck ratio was 1.81 ± 0.55 and 1.55 ± 0.48 for 2D DSA and 3DRA, respectively (P &amp;lt; .0001). When we defined “wide-neck” as a dome-to-neck ratio &amp;lt;1.5, sixty-nine (33.7%) aneurysms were wide-neck on 2D DSA compared with 119 (58%) on 3DRA (P &amp;lt; .0001). When we defined “wide-neck” as dome-to-neck ratio &amp;lt;2.0, one hundred forty-two (69.3%) aneurysms were wide-neck on 2D DSA compared with 173 (84.4%) on 3DRA (P = .0004).CONCLUSIONS: In this retrospective study, 3DRA measurements resulted in significantly lower dome-to-neck ratios and significantly larger proportions of aneurysms defined as “wide-neck” compared with 2D DSA. Scrutiny of 2D DSA may offer substantial benefit over 3D techniques when triaging patients to or from endovascular therapy.