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        "titulo" => "Resumen"
        "resumen" => "<span class="elsevierStyleSectionTitle">Objetivos</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Demostrar el valor de la exploraci&#243;n mediante angiotomograf&#237;a computarizada helicoidal con reconstrucci&#243;n tridimensional &#40;angio-TC-3D&#41; en el manejo de los pacientes que han sufrido una hemorragia subaracnoidea &#40;HSA&#41; aguda&#46;</p> <span class="elsevierStyleSectionTitle">Material y M&#233;todos</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Se estudiaron 20 pacientes con HSA aguda&#46; Se realiza un TC helicoidal 20 s tras el inicio de la administraci&#243;n intravenosa de 90<span class="elsevierStyleHsp" style=""></span>ml de contraste no i&#243;nico mediante bomba a un flujo de 2&#46;5<span class="elsevierStyleHsp" style=""></span>ml&#47;s&#46; Las im&#225;genes se env&#237;an a una &#8220;workstation&#8221; donde se procesan para obtener im&#225;genes del &#225;rbol vascular en modos SSP o &#8220;shadow surface display&#8221; y MIP o &#8220;maximal intensity process&#8221;&#46;</p> <span class="elsevierStyleSectionTitle">Resultados</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">No se obtuvieron falsos positivos en relaci&#243;n a los hallazgos angiogr&#225;ficos o quir&#250;rgicos&#46; Un aneurisma infraclinoideo de car&#243;tida interna no roto no fue detectado mediante angio-TC-3D&#46; Dos aneurismas no diagnosticados con fiabilidad mediante angiograf&#237;a fueron identificados con angio-TC-3D&#46; Finalmente&#44; un peque&#241;o aneurisma del territorio de comunicante posterior no roto fue encontrado durante la cirug&#237;a sin ser identificable ni en la angiograf&#237;a ni angioTC-3D&#46; La angio-TC-3D demostr&#243; todos los aneurismas que hab&#237;an sido responsables de la HSA&#46; Cinco pacientes con HSA fueron intervenidos de su aneurisma s&#243;lo con los datos aportados por&#58; la angio-TC-3D&#46;</p> <span class="elsevierStyleSectionTitle">Conclusiones</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Nuestra experiencia sugiere que la angio-TC-3D puede ser &#250;til en el diagn&#243;stico inmediato del aneurisma cerebral como causa de la HSA y que en casos seleccionados puede plantearse el tratamiento quir&#250;rgico del mismo bas&#225;ndose &#250;nicamente en los datos aportados por la angio-TC-3D&#46;</p>"
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        "titulo" => "Summary"
        "resumen" => "<span class="elsevierStyleSectionTitle">Objective</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">To demonstrate the usefulness of threedimensional helicoidal computed tomographic angiography &#40;angio-CT-3D&#41; in the management of patients with acute subarachnoid hemorrhage &#40;SAH&#41;&#46;</p> <span class="elsevierStyleSectionTitle">Materials and Methods</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">A CT helicoidal acquisition was obtained 20 s after the starting of an intravenous administration of 90<span class="elsevierStyleHsp" style=""></span>ml of non-ionic contrast injected at arate of 2&#46;5<span class="elsevierStyleHsp" style=""></span>ml&#47;min&#46; Axial images were transferred on a workstation obtaining images of the vascular tree in SSP &#40;shadow surface display&#41; and MIP &#40;maximal intensity process&#41; modes&#46; A total of 20 patients with acute SAH were studied&#46;</p> <span class="elsevierStyleSectionTitle">Results</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">There were no false positive findings&#46; One intact infraclinoidal carotid aneurysm was missed but two lesions not clearly showed in angiography were shown in angio-CT-3D study&#46; One intact microaneurysm not seen in angiography nor in angio-CT-3D was found at surgery in the posterior communicating area&#46; AIl bleeding lesions were found in angio-CT-3D&#46; Five patients with acute HSA were operated on based only on angio-CT-3D findings&#46;</p> <span class="elsevierStyleSectionTitle">Conclusion</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Our experience suggest that angio-CT3D is useful in the rapid and accurate diagnosis of the cerebral aneurysm as the cause of SAH&#46; In selected cases it is possible to operate on the lesion based only on angio-CT-3D findings&#46;</p>"
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Vol. 11. Núm. 1.
Páginas 23-30 (enero 1999)
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Vol. 11. Núm. 1.
Páginas 23-30 (enero 1999)
Experiencia inicial con la angio-TC-3D en el manejo de la hemorragia subaracnoidea y de los aneurismas cerebrales
Visitas
1910
J.M. González-Darder, J.V. Pesudo-Martínez
Sección de Neurocirugía. Hosp. Gral. de Castellón. Servicio Valenciano de Salud. Castellón de la Plana
J. Cervera-Deval*, R. Gómez-Melchor*, J. Tudela*, J. GarcíaVila*
* Servicio de Radiodiagnóstico. Hosp. Gral. de Castellón. Servicio Valenciano de Salud. Castellón de la Plana
Este artículo ha recibido
Información del artículo
Resumen
Objetivos

Demostrar el valor de la exploración mediante angiotomografía computarizada helicoidal con reconstrucción tridimensional (angio-TC-3D) en el manejo de los pacientes que han sufrido una hemorragia subaracnoidea (HSA) aguda.

Material y Métodos

Se estudiaron 20 pacientes con HSA aguda. Se realiza un TC helicoidal 20 s tras el inicio de la administración intravenosa de 90ml de contraste no iónico mediante bomba a un flujo de 2.5ml/s. Las imágenes se envían a una “workstation” donde se procesan para obtener imágenes del árbol vascular en modos SSP o “shadow surface display” y MIP o “maximal intensity process”.

Resultados

No se obtuvieron falsos positivos en relación a los hallazgos angiográficos o quirúrgicos. Un aneurisma infraclinoideo de carótida interna no roto no fue detectado mediante angio-TC-3D. Dos aneurismas no diagnosticados con fiabilidad mediante angiografía fueron identificados con angio-TC-3D. Finalmente, un pequeño aneurisma del territorio de comunicante posterior no roto fue encontrado durante la cirugía sin ser identificable ni en la angiografía ni angioTC-3D. La angio-TC-3D demostró todos los aneurismas que habían sido responsables de la HSA. Cinco pacientes con HSA fueron intervenidos de su aneurisma sólo con los datos aportados por: la angio-TC-3D.

Conclusiones

Nuestra experiencia sugiere que la angio-TC-3D puede ser útil en el diagnóstico inmediato del aneurisma cerebral como causa de la HSA y que en casos seleccionados puede plantearse el tratamiento quirúrgico del mismo basándose únicamente en los datos aportados por la angio-TC-3D.

Palabras clave:
Hemorragia subaracnoidea
Aneurisma cerebral
Angiografía por tomografía computada
Summary
Objective

To demonstrate the usefulness of threedimensional helicoidal computed tomographic angiography (angio-CT-3D) in the management of patients with acute subarachnoid hemorrhage (SAH).

Materials and Methods

A CT helicoidal acquisition was obtained 20 s after the starting of an intravenous administration of 90ml of non-ionic contrast injected at arate of 2.5ml/min. Axial images were transferred on a workstation obtaining images of the vascular tree in SSP (shadow surface display) and MIP (maximal intensity process) modes. A total of 20 patients with acute SAH were studied.

Results

There were no false positive findings. One intact infraclinoidal carotid aneurysm was missed but two lesions not clearly showed in angiography were shown in angio-CT-3D study. One intact microaneurysm not seen in angiography nor in angio-CT-3D was found at surgery in the posterior communicating area. AIl bleeding lesions were found in angio-CT-3D. Five patients with acute HSA were operated on based only on angio-CT-3D findings.

Conclusion

Our experience suggest that angio-CT3D is useful in the rapid and accurate diagnosis of the cerebral aneurysm as the cause of SAH. In selected cases it is possible to operate on the lesion based only on angio-CT-3D findings.

Key words:
Subarachnoid hemorrhage
Cerebral aneurysm
Computed tomography angiography

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