A Fundamental Study of the Energy Subtraction Processing Using a Monochromatic Image for Computed Tomography Angiography after Coil Embolization of a Cerebral Aneurysm

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  • Sasamori Daisuke
    Department of Radiological Technology, Sapporo Shiroishi Memorial Hospital
  • Nonaka Tadashi
    Department of Neuroendovascular Therapy, Sapporo Shiroishi Memorial Hospital
  • Takahashi Akira
    Department of Neuroendovascular Therapy, Sapporo Shiroishi Memorial Hospital
  • Kayano Shingo
    Department of Radiological Technology, Sapporo Shiroishi Memorial Hospital
  • Yamashita Tomofumi
    Department of Radiological Technology, Sapporo Shiroishi Memorial Hospital
  • Irii Ryousuke
    Department of Radiological Technology, Sapporo Shiroishi Memorial Hospital
  • Tanikoshi Tetsuya
    Department of Radiological Technology, Sapporo Shiroishi Memorial Hospital
  • Akagawa Makoto
    Department of Radiological Technology, Sapporo Shiroishi Memorial Hospital

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Other Title
  • 脳動脈瘤コイル塞栓術後CT Angiographyにおける単色X線等価画像を用いたエネルギーサブトラクション処理の基礎的検討
  • ノウ ドウミャクリュウ コイル ソクセン ジュツゴ CT Angiography ニ オケル タンショク Xセン トウカ ガゾウ オ モチイタ エネルギーサブトラクション ショリ ノ キソテキ ケントウ

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Coil-embolized cerebral aneurysms are difficult to evaluate using computed tomography (CT) angiography (CTA) due to artifacts caused by the coil devices. This study was conducted to assess the practicality of energy subtraction processing using monochromatic images obtained using CTA after coil embolization of a cerebral aneurysm. In this study, the changes in the CT value of the contrast agent and the coil were analyzed not only at varying monochromatic energy levels but also by energy subtraction processing. Our analyses revealed an exponential change in the CT value of the contrast agent at any desired energy. We also found that the CT value of the coil was unchanged at the upper threshold of the grayscale limit. Based on these results, we were able to create images of changes in material-specific CT values and thus eliminate the material. Energy subtraction processing enabled us to distinguish between the contrast agent, the coil, and the artifacts from coil devices. We suggest that energy subtraction processing using monochromatic images can resolve the limitations of CTA after coil embolization of cerebral aneurysms.

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