ArticleNeurosurgical review2022
The impact of high-resolution cone-beam CT findings on decision-making for the treatment of unruptured middle cerebral artery aneurysms.
Article in Neurosurgical review, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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4 citing papers in PubMed, 5 citations in OpenAlex.
- Comparison of 5.0T and 3.0T time-of-flight MR angiography for visualizing the anterior choroidal artery.BMC neurology · 2026Article
- High-resolution cone-beam CT (DynaCT Micro) enhances preoperative and intraoperative visualization of intracranial perforator arteries.Neuroradiology · 2026Article
- Diagnosis of Unruptured Intracranial Aneurysms Using Proton-Density Magnetic Resonance Angiography: A Comparison With High-Resolution Time-of-Flight Magnetic Resonance Angiography.Korean journal of radiology · 2024Article
- Visualization of the lenticulostriate arteries, long insular arteries, and long medullary arteries on intra-arterial computed tomography angiography with ultrahigh resolution in patients with glioma.Acta neurochirurgica · 2023Article
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Authors and funding
8 authors at 3 institutions in 1 country.
Funding
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Abstract
Even with the advent of endovascular treatment for intracranial aneurysms, microsurgical clipping continues to play a significant role in the treatment of middle cerebral artery (MCA) aneurysms. Securing perforators around unruptured intracranial aneurysms (UIAs) is essential for minimizing procedural risks in each treatment option. Therefore, we herein investigated whether the findings of high-resolution cone-beam computed tomography (HR-CBCT) have an impact on decision-making for the treatment of MCA UIAs. Patients with MCA UIAs between October 2017 and September 2021 were consecutively recruited for this study. All patients underwent HR-CBCT and 3D-DSA before treatment. The imaging quality of both modalities to visualize the microvasculature around aneurysms was evaluated. Specific findings on the microvasculature surrounding aneurysms on HR-CBCT were investigated to facilitate microsurgical clipping. Fifty-two MCA UIAs were treated, including 43 by microsurgical clipping and 9 by endovascular approaches. The overall imaging quality of HR-CBCT was superior to that of 3D-DSA. Regarding microsurgical insights, sensitivity and specificity for the visualization of small vessels around aneurysms were 79 and 100%, respectively, using HR-CBCT, and 57 and 93%, respectively, using 3D-DSA. The presence of a low-density band between adhesive vessels and aneurysm sacs was indicative of successful and safe microsurgical dissection between these structures. HR-CBCT enabled visualization of the intracranial microvasculature around MCA UIAs at the submillimeter level in vivo. In cases in which the tight adhesion of the microvasculature to the aneurysm sac is indicated by HR-CBCT, an endovascular approach may be considered in order to avoid the risks associated with securing perforators.
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