Subtraction effect of volume CT digital subtraction angiography versus CT angiography with matched mask bone elimination of the head and neck in patients with intracranial aneurysm：a comparative study

Abstract:

Objective：To compare the subtraction effect of volume computed tomography digital subtraction angiography（VCTDSA） and computed tomography angiography with matched mask bone elimination（MMBE） of the head and neck in patients with intracra－nial aneurysm. Methods：A retrospective analysis was conducted on the data of 47 patients who underwent a computed tomography angiography（CTA） of the head and neck and were diagnosed with intracranial aneurysm in our hospital from March 2017 to March 2018. The original images from the head and neck CTA of the above 47 patients were post-processed using the VCTDSA technique on a GE AW4.6 workstation and the MMBE technique on a SIEMENS Syngovia workstation，respectively；the two techniques were compared in terms of automatic subtraction time，manual subtraction time，and total subtraction time；moreover，the bone removal effect after subtraction，blood vessel subtraction effect，and aneurysm display effect were also evaluated. Results：There were significant dif－ferences between VCTDSA and MMBE in the automatic subtraction time，manual subtraction time，and total subtraction time（12 s vs. 76 s，598 s vs. 288 s，and 561.5 s vs. 375 s，respectively）. VCTDSA was significantly superior to MMBE in the subtraction effect of the intracranial segment and the venous sinus of the internal carotid artery as well as in the aneurysm display effect（P<0.01），but was significantly inferior to MMBE in the bone removal effect after subtraction（P<0.01）. For aneurysms of the internal carotid artery siphon，VCTDSA was significantly superior to MMBE in the a－neurysm display effect（P<0.01）. Conclusion：VCTDSA has a high speed of automatic bone removal with a satisfactory effect，and is superior to MMBE in the display effect of blood vessels and aneurysms of the head and neck，which contributes to the observation and diagnosis of intracranial aneurysms. MMBE has a better automatic bone removal effect and can reduce manual subtraction time，but it may achieve a poor overall subtraction effect due to false vascular stenosis and incomplete display of aneurysms caused by excessive subtraction，which is not conducive to the diagnosis of intracranial aneurysms.