High prevalence of intracranial aneurysms in patients with aortic dissection or aneurysm: feasibility of extended aorta CT angiography with involvement of intracranial arteries.
BACKGROUND
Previous studies have suggested a higher prevalence of intracranial aneurysms (IAs) in patients with aortic aneurysms (AAs).


OBJECTIVE
To carry out a preliminary study to evaluate the prevalence of IAs in these patients and the diagnostic feasibility of extended aorta CT angiography (CTA), including intracranial arteries as well as the aorta.


METHODS
We retrospectively reviewed all patients with a clinical diagnosis of AA or aortic dissection (AD) who had undergone aorta CTA as well as MR angiography, CTA, and/or DSA of the brain between 2009 and 2014. Since 2012, the extended aorta CTA protocol has been applied in these patients. Characteristics of IAs were classified with baseline clinical data. For quantitative and qualitative assessment by two independent raters, brain images obtained by extended aorta CTA and brain CTA were compared. The radiation dose of the two aorta protocols was compared.


RESULTS
The prevalence of IA was 22.2% (35/158). All IAs were detected by extended aorta CTA, except one small aneurysm (<3 mm). The mean vascular attenuation value between brain images showed no difference (p=0.83), but the contrast-to-noise ratio was significantly lower in extended aorta CTA (p<0.001). In qualitative assessment, the interobserver agreement was substantial (k=0.79). For the radiation dose, the dose-length product of the extended aorta CTA increased with increment of the scan range (p=0.048).


CONCLUSIONS
With a high prevalence of IAs in patients with ADs or AAs, extended aorta CTA could be used to evaluate aorta disease and IA in a single session. However, further prospective studies are needed to prove efficacy and safety of the extended aorta CTA protocol in patients with AAs or ADs.
Department of Radiology, Gangnam Severance Hospital, Yonsei University, Seoul, Korea.
Dahye
D
Lee
Department of Radiology, Gangnam Severance Hospital, Yonsei University, Seoul, Korea.
Sung Jun
SJ
Ahn
Department of Radiology, Gangnam Severance Hospital, Yonsei University, Seoul, Korea.
Eun-Suk
ES
Cho
Department of Neurosurgery, Gangnam Severance Hospital, Yonsei University, Seoul, Korea.
Yong Bae
YB
Kim
Department of Cardiovascular Surgery, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
Suk-Won
SW
Song
Department of Radiology, Gangnam Severance Hospital, Yonsei University, Seoul, Korea.
Woo Sang
WS
Jung
Department of Radiology, Gangnam Severance Hospital, Yonsei University, Seoul, Korea.|Severance Institute of Vascular and Metabolic Research, Yonsei University College of Medicine, Seoul, Korea.
Sang Hyun
SH
Suh
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000784:Aortic Dissection / Q000000981:diagnostic imaging* / Q000453:epidemiology; D001014:Aortic Aneurysm / Q000000981:diagnostic imaging* / Q000453:epidemiology; D002533:Cerebral Angiography / Q000379:methods / Q000639:trends*; D002536:Cerebral Arteries / Q000000981:diagnostic imaging*; D000072226:Computed Tomography Angiography / Q000379:methods / Q000639:trends*; D005240:Feasibility Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D002532:Intracranial Aneurysm / Q000000981:diagnostic imaging* / Q000453:epidemiology; D008875:Middle Aged; D015995:Prevalence; D011446:Prospective Studies; D012189:Retrospective Studies
Aneurysm; CT Angiography