Bone subtraction CTA for transcranial arteries: intra-individual comparison with standard CTA without bone subtraction and TOF-MRA

Buerke, B.; Puesken, M.; Wittkamp, G.; Stehling, C.; Ditt, H.; Seidensticker, P.; Wessling, J.; Heindel, W.; Kloska, S.P.

doi:10.1016/j.crad.2010.03.002

« Previous Next »Clinical Radiology
Volume 65, Issue 6 , Pages 440-446, June 2010

Bone subtraction CTA for transcranial arteries: intra-individual comparison with standard CTA without bone subtraction and TOF-MRA

B. Buerke
- Department of Clinical Radiology, University of Muenster, Muenster, Germany
- Guarantor and correspondent: B. Buerke, Department of Clinical Radiology, University of Muenster, Albert-Schweitzer-Straße 33, 48149 Muenster, Germany. Tel.: +49 251 83 47305; fax: +49 251 83 45127.
M. Puesken
- Department of Clinical Radiology, University of Muenster, Muenster, Germany
G. Wittkamp
- Department of Clinical Radiology, University of Muenster, Muenster, Germany
C. Stehling
- Department of Clinical Radiology, University of Muenster, Muenster, Germany
H. Ditt
- Siemens AG, Healthcare Sector, Forchheim, Germany
P. Seidensticker
- Bayer–Schering–Pharma AG, Global Medical Affairs Diagnostic Imaging, Berlin, Germany
J. Wessling
- Department of Clinical Radiology, University of Muenster, Muenster, Germany
W. Heindel
- Department of Clinical Radiology, University of Muenster, Muenster, Germany
S.P. Kloska
- Department of Clinical Radiology, University of Muenster, Muenster, Germany

Received 20 August 2009; received in revised form 14 February 2010; accepted 2 March 2010. published online 20 April 2010.

Aim

To evaluate the impact of bone subtraction computed tomography angiography (BS-CTA) for the assessment of transcranial arteries in comparison with standard CTA (S-CTA) without bone removal and time-of-flight magnetic resonance angiography (TOF-MRA).

Materials and methods

Cranial unenhanced CT and S-CTA were performed in 53 patients with suspected cerebrovascular disease. BS-CTA datasets were reconstructed from the S-CTA and unenhanced CT source images. TOF-MRA was performed within 24h after CTA on a 1.5 T MRI system. Two radiologists, in consensus, evaluated the segments of the internal carotid artery (C2–C7), the vertebral artery (V4), and the basilar artery for the degree of stenosis. A five-step scale (0–49, 50–69, 70–89, 90–99% and occlusion) for the degree of stenosis was applied for all segments. Wilcoxon's signed rank test was used for statistical analysis.

Results

Seven hundred and fifty vessel segments (ICA:636, VA:106, BA:53) were analysed. The degree of stenosis on S-CTA was consistent with TOF-MRA in all segments. BS-CTA showed a trend towards higher stenosis scores in cases of calcified plaques compared to S-CTA (p=0.11) and TOF-MRA (p=0.09), which was not statistically significant. In transcranial segments, BS-CTA revealed equivalent scores compared to S-CTA and TOF-MRA (p=0.25; p=0.20).

Conclusion

BS-CTA produced similar results to TOF-MRA and S-CTA and can be applied as a non-invasive imaging method for the transcranial arteries. However, BS-CTA shows a trend towards overestimation of the degree of stenosis.