Article Figures & Data
Figures
- Fig 1.
A 46-year-old man with an aneurysm of the distal MCA. A, Unenhanced CT scan demonstrates hemorrhage (arrow) in the right parietal lobe with mild surrounding edema. B and C, Left anterior oblique projection of the volume-rendered image (B) and the coronal multiplanar reformatted image (C) from MDCTA demonstrates a 2.5-mm saccular aneurysm (arrow) at the distal branch of the right MCA with an upward orientation of the sac. Note the relationship of the hematoma (arrowheads) to the aneurysm. D, DSA image of the right ICA, anteroposterior projection, shows the same aneurysm (arrow), which was confirmed at surgical exploration.
- Fig 2.
A 29-year-old man with an arteriovenous malformation. A, Unenhanced CT scan demonstrates hemorrhage (arrow) in the right frontal lobe. B, Volume-rendered MDCTA image, lateral projection, clearly demonstrates the abnormal collections of vessels in the right frontal lobe (arrowhead) and the enlarged draining cortical veins (arrows). C, Corresponding DSA image of the right ICA confirms these findings, demonstrating the nidus (arrowhead) and the early draining veins (arrows).
- Fig 3.
A 28-year-old woman with Moyamoya disease. A, Unenhanced CT scan demonstrates pericallosal hematoma (arrow) with extension of hemorrhage into the lateral ventricle. B, Volume-rendered MDCTA image with bone subtraction, anteroposterior projection, demonstrates symmetric occlusion of the bilateral proximal MCAs (arrows). MDCTA image fails to show collateral vessels. C and D, Corresponding DSA images of the right (C) and left (D) carotid arteries, anteroposterior projection, confirm occlusion of the bilateral proximal MCAs (arrows). In addition, reconstitution of the distal MCAs via fine collateral vessels is also noted.
Tables
Patient No. Age (yr)/Sex Location N/D Ratio Orientation Lobularity Branches from Aneurysm Severe Vasospasm* DSA MDCTA DSA MDCTA MDCTA DSA DSA MDCTA DSA MDCTA 1 48/F AcomA <1/3 Same Anterior Same Multi- Same (–) Same Bilateral A1, A2; left M2 Same 2 40/F MCAB <1/3 1/3–2/3 Superior Same Single- Same (–) Same (–) Same 3 56/M MCAB 1/3–2/3 Same Superior Same Multi- Same Neck Same (–) Same 4 33/F AcomA >2/3 Same Inferior Same Multi- Same (–) Same (–) Same 5 39/F AcomA <1/3 Same Superior Same Single- Same (–) Same (–) Same 6 54/M MCAB <1/3 Same Inferior Same Single- Same Neck Same (–) Same 7 40/M Distal ICA >2/3 Same Superior Same Multi- Same (–) Same (–) Same 8 51/M MCAB 1/3–2/3 Same Lateral Same Single- Same Dome Same Right M2 Same 9 42/F MCAB >2/3 Same Lateral Same Multi- Same Neck Same (–) Same 10 46/M Distal MCA 1/3–2/3 Same Superior Same Single- Same (–) Same (–) Same 11 44/M Distal ACA 1/3–2/3 Same Anterior Same Single- Same (–) Same (–) Same Note:—AcomA indicates anterior communicating artery; MCAB, MCA bifurcation; A1, first segment of the ACA; A2, second segment of the ACA; M2, second segment of the MCA; DSA, digital subtraction angiography; ICA, internal carotid artery; MCA, middle cerebral artery; ACA, anterior cerebral artery.
* Arterial spasm was categorized as severe when the vessel diameters were reduced by >50%.
Patient No. Age (yr)/Sex Location Feeding Arteries Nidus Draining Veins DSA MDCTA DSA MDCTA DSA MDCTA 1 29/M Frontal lobe ACA Same Visible Same Cortical veins, SSS Same 2 25/F Frontal lobe ACA Not visible Visible Not visible Deep veins, ICV Same 3 44/F Frontal lobe MCA, ACA Not visible Visible Same Cortical veins, SSS Same 4 30/F Temporal lobe MCA Same Visible Same Cortical veins, SSS Same 5 35/F Frontal lobe ACA Same Visible Same Cortical veins, SSS Same 6 31/M Occipital lobe PCA Same Visible Same Cortical veins, SS Same 7 55/M Parietal lobe MCA Not visible Visible Not visible Cortical veins, SSS Not visible Note:—SSS indicates superior sagittal sinus; ICV, internal cerebral vein; SS, sigmoid sinus; AVM, arteriovenous malformation; PCA, posterior cerebral artery.
Patient No. Age (yr)/Sex Site of Occlusion Collateral Vessels DSA MDCTA DSA MDCTA 1 28/F Bilateral M1 Same Basal Not visible 2 31/F Bilateral ICA Same Basal, leptomeningeal Not visible 3 47/F Bilateral ICA Same Basal, leptomeningeal, transdural Not visible 4 38/F Unilateral ICA Same Basal, leptomeningeal Not visible Note:—M1 indicates the first segment of the MCA.
- Table 4:
Diagnostic performance of MDCTA for the detection of underlying vascular abnormalities causing spontaneous lobar intracerebral hemorrhage in 78 patients
TP Cases TN Cases FP Cases FN Cases Sensitivity (%) Specificity (%) PPV (%) NPV (%) Accuracy (%) 21 56 0 1 95.5 100 100 98.2 98.7 Note:—TP indicates true-positive; TN, true-negative; FP, false-positive; FN, false-negative; PPV, positive predictive value; NPV, negative predictive value; MDCTA, multidetector row CT angiography.
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