Reliability study of advanced vascular analysis software and volume ＣＴ digital subtraction angiography for bone subtraction on ＣＴ angiography

Abstract:

Objective：To evaluate the reliability of advanced vascular analysis（AVA） software and volume computed tomography digital subtraction angiography（VCTDSA） for bone subtraction on computed tomography angiography（CTA） of the normal head and neck. Methods：The imaging data of normal head and neck CTA for 30 subjects in the First Affiliated Hospital of Chongqing Medical University were retrospectively analyzed. The same operator used AVA software and VCTDSA for bone-subtraction in the original images，recorded the time of automatic subtraction，manual subtraction，and total subtraction，and evaluated the VR and MIP images in the aspects of vascular integrity，image quality，and false vascular stenosis. The Mann-Whitney U test was used to compare the subtraction time，the paired chi-square test was used to evaluate vascular integrity，and the rank sum test for dependent samples was used to evaluate image quality and false vascular stenosis. Results：The time of automatic subtraction，manual subtraction，and total subtraction of VCTDSA was 14.5（13，20.25） seconds，399（353.75，501.75） seconds，and 415.5（371.5，516） seconds，respectively，while that of AVA was 116.5（109，123.25） seconds，11.5（0，71.25） seconds，and 140（115.5，188） seconds，respectively. The time of manual subtraction and total subtraction of AVA was significantly shorter than that of VCTDSA（P<0.01）. The display rates of the M4 and M5 regions，intracranial bridging veins，superior sagittal sinus，transverse sinus，and sigmoid sinus for AVA and VCTDSA were 0 and 93.33%（140/150），respectively，with a significant difference（P<0.01）. The image quality of internal carotid artery（ICA） 2 and ICA6 of VCTDSA was better than that of AVA（P<0.01）；the percentages of grade I images of ICA2 and ICA6 on VCTDSA were 86.21% （25/29） and 96.55% （28/29），respectively，versus 44.83%（13/29） and 58.62%（17/29） for AVA. The rate of false vascular stenosis showed no significant difference between CTDSA and AVA[1.41%（10/711） vs. 1.13%（8/711），P>0.01]. Conclusion：VCTDSA has a more reliable bone-subtraction effect than AVA on CTA，and it should be used as the preferred bone-subtraction method.