المؤلفون: Saberi, Hooshang, Hashemi, Mohammad, Habibi, Zohreh, Meybodi, Ali Tayebi, Ali, Seyed, Tabatabai, Fakhr, Saberi, Hazhir, Saboori, Sofia

المصدر: Iranian Journal of Radiology; 2011, Vol. 8 Issue 3, p139-144, 6p

مصطلحات موضوعية: DIGITAL subtraction angiography, INTRACRANIAL aneurysm diagnosis, SUBARACHNOID hemorrhage, SPIRAL computed tomography, MEDICAL imaging systems

مستخلص: Background: Conventional angiography, generally referred to as intra-arterial digital subtraction angiography, still remains the gold standard reference method for the diagnosis of intracranial aneurysms, helical computed tomography angiography (CTA) is a new non-invasive volumetric imaging method. Objectives: This study was conducted to screen patients presenting with subarachnoidhemorrhage by CTA before conventional digital subtraction angiography (DSA) and subsequently comparing the results for various aneurysm projections. Patients and Methods: In a prospective study, 99 consecutive patients with an initial diagnosis of subarachnoid hemorrhage were screened for aneurysms with CTA followed by conventional DSA. There were 17 cases with negative angiograms in whom repeat angiograms, three months later were negative for 15 cases, while two cases were found to bear aneurysm on the repeat examination. Eighty two patients had at least one proven aneurysm on initial DSA and two on the repeat angiogram. Out of 84 patients, five underwent endovascular treatment and 79 patients who underwent surgical clipping were considered for projection evaluation. Results: Sensitivity of CTA was 98.78% (95% confidence interval [CI], 93.4-99.7%), while the specificity was 100% (95% CI, 81.57-100%) and the kappa coefficient of agreement between CTA and DSA was 96.5%. The most significant discrepancies with DSA findings were for visualizing the projection of inferior and posterior projecting proximal anterior circulation aneurysms. Conclusions: Helical CTA was in good concordance with DSA for screening of cerebral aneurysms; however, for exact visualization of the aneurysm neck and its projection, especially if it is inferior or posterior, DSA remains the gold standard. [ABSTRACT FROM AUTHOR]

: Copyright of Iranian Journal of Radiology is the property of Tehran University of Medical Sciences and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

المؤلفون: Bitaraf, Mohammad Ali, Azar, Mazyar, Miri, Seyed Mojtaba, Sheikhrezai, Abdolreza, Alikhani, Mazdak, Allahverdi, Mahmud, Tabrizi, Ahmad Sharif, Meybodi, Ali Tayebi

المصدر: Tehran University Medical Journal; Jun2010, Vol. 68 Issue 3, p162-167, 6p

مصطلحات موضوعية: MENINGIOMA, BRAIN tumors, RADIOSURGERY, EDEMA, THERAPEUTICS

مصطلحات جغرافية: IRAN

مستخلص: Background: Meningiomas are among the most common tumors of the brain. Skull base meningiomas comprise s major part of brain meningiomas. They are difficult to treat because of proximity to major vital neuro-vascular structures which makes their surgical resection hazardous and fraught with a high rate of complications. Radiosurgery is considered as an alternative efficient way to treat them, which targets the tumor and its supplying vasculature. The standard treatment consists of tumor eradication and its supplying vessels through homogeneous dose of 201 rays of cobalt 60 source. Methods: In a case-series study, we report 230 meningiomas referred to Iraninan Gamma Knife Center, treated by radiosurgery with type C Gamma Knife. Radio-surgery was performed at a mean dose of 15 Gy and 50% isodose. Results: Two hundred and thirty of all meningioma cases refered to our institute were skull base lesions. Eighty (35%) were new case and the rest were previously treated microsurgically one or more times. None of the patients died after treatment and the most common post-operative complications were headache (30 patients) and peritumoral edema (12 patients). Conclusion: Tumoral control is defined as reduced tumor volume or as no change in tumor volume. Tumor control was achieved in 218 (95%) patients. In those who were not treated microsurgically, clinical improvement was more pronounced. Thus when suitable (favorable tumor size and absence of progressive mass effect signs) the patients could be primarily treated with Gamma knife. Other patients could be managed complementarily with radiosurgery after they are treated surgically. [ABSTRACT FROM AUTHOR]

: Copyright of Tehran University Medical Journal is the property of Tehran University of Medical Sciences and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)