A compartmentalized volumetric system for outcome analysis of coiled cerebral aneurysms: aneurysm-coil mass-neck outcome assessment system.
OBJECTIVE
Current methodologies for outcome assessment of coiled cerebral aneurysms are based on rough estimations. The aim of this study was to develop a system of quantitative analysis for objective and accurate assessment of the outcome of cerebral aneurysms treated with coil embolization.


METHODS
The quantitative analysis system is based on a concept of a perfect vessel tube and compartmentalized analysis of a coiled aneurysm. Based on the volumetric data of 3-dimensional radiographic angiography of the aneurysm and its associated parent vessel, a 2-step volume extraction method, including a global thresholding method and an augmented vessel method, is used for volume calculation. The coiled aneurysm (A) is compartmentalized into 2 volumetric components for quantitative analysis: 1) the volume of the coil mass (C), and 2) the volume of the uncoiled neck of the aneurysm (N). Changes in the volumetric data of the compartments A, C, and N at the time of follow-up provide a basis for outcome analysis. To test the clinical applicability of the system, the volumetric data for 21 consecutive cases of cerebral aneurysms in which a residual or recurrent cavity at the neck region was noted at the time of the 6-month follow-up evaluation were assessed with the aneurysm-coil mass-neck (ACN) outcome assessment system.


RESULTS
The results of the outcome analysis of the 21 cases according to the ACN system correlated well with angiographic assessment of treatment outcome.


CONCLUSIONS
The ACN outcome assessment system is a useful diagnostic instrument for objective and accurate assessment of the outcome of cerebral aneurysms treated with coil embolization.
Yu
Simon C H
SC
Department of Diagnostic Radiology and Organ Imaging, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong. simonyu@cuhk.edu.hk
So
Wai King
WK
Chung
Albert Chi Shing
AC
Lee
Kwok Tung
KT
Wong
George Kwok Chu
GK
D002533:Cerebral Angiography; D004621:Embolization, Therapeutic; D006801:Humans; D021621:Imaging, Three-Dimensional / Q000379:methods*; D002532:Intracranial Aneurysm / Q000473:pathology* / Q000628:therapy*; D016896:Treatment Outcome