title: 3D rotational angiography with volume rendering: the utility in the detection of intracranial aneurysms.
abstract: OBJECTIVE
  The advent of three-dimensional (3D) rotational angiography (3D DSA) challenged the role of digital subtraction angiography (DSA) as a "gold standard" in the diagnosis of intracranial aneurysms. In this study, we report our experiences in diagnosing intracranial aneurysms by using 3D DSA with volume rendering (VR) technique, particularly focusing on its role in depicting additional aneurysms missed by 2D DSA.
  
  
  METHODS
  One hundred and thirty-eight consecutive patients with known or suspected aneurysms (54 men, 84 women; median age, 55 years; age range, 18-83 years) underwent both conventional DSA and 3D DSA with VR examination simultaneously. The images of 2D DSA or 3D DSA with VR were evaluated by two observers independently for the presence of aneurysms. Then additional aneurysms were decided and depicted.
  
  
  RESULTS
  3D DSA with VR showed 146 aneurysms in 123 (89.1%) of 138 patients and no aneurysms in 15 patients. 2D DSA showed 115 aneurysms in 110 of 137 patients, with one aneurysm in 106 patients each, 2 in 3 patients each and 3 in 1 patient. After reaching a consensus, there were 31 additional aneurysms detected by 3D DSA with VR. 30 aneurysms were <3 mm in maximum diameter with 3 aneurysms ruptured. These additional aneurysms were located in internal carotid artery (ICA, n = 28, 90.32%), anterior cerebral artery (ACA, n = 3, 9.68%). No additional aneurysms were found in either middle cerebral artery (MCA) or vertebrobasilar and posterior cerebral artery (PCA) systems.
  
  
  CONCLUSIONS
  3D DSA, especially VR images, not only clearly reveals aneurysms and aneurysmal morphology, but also detects additional aneurysms missed by 2D DSA, especially small aneurysms less than 3 mm.
authors.affiliation: Institute of Diagnostic and Interventional Radiology, Jiao Tong University, Shanghai, People's Republic of China.
authors.forename: Wan-Yin
authors.initials: WY
authors.lastname: Shi
authors.forename: Yong-Dong
authors.initials: YD
authors.lastname: Li
authors.forename: Ming-Hua
authors.initials: MH
authors.lastname: Li
authors.forename: Bin-Xian
authors.initials: BX
authors.lastname: Gu
authors.forename: Shi-Wen
authors.initials: SW
authors.lastname: Chen
authors.forename: Wu
authors.initials: W
authors.lastname: Wang
authors.forename: Bei-Lei
authors.initials: BL
authors.lastname: Zhang
authors.forename: Min
authors.initials: M
authors.lastname: Li
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015901:Angiography, Digital Subtraction / Q000379:methods*; D001931:Brain Mapping; D002533:Cerebral Angiography / Q000379:methods*; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional / Q000379:methods*; D002532:Intracranial Aneurysm / Q000000981:diagnostic imaging* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D055815:Young Adult