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Fusion of subarachnoid hemorrhage data and computed tomography angiography data is helpful to identify the rupture source in patients with multiple intracranial aneurysms

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Abstract

Determining the rupture source is imperative in patient with aneurysmal subarachnoid hemorrhage (SAH). About one third of SAH cases with multiple intracranial aneurysms cannot be certain of the rupture source according to the hemorrhage pattern. This study aims to identify of the rupture source in patients with multiple intracranial aneurysms by fusing SAH data and computed tomography angiography (CTA) data. This retrospective study included 52 aneurysmal SAH patients with multiple intracranial aneurysms. In the 52 patients, 36 had definitive hemorrhage patterns on computed tomography imaging. And the other 16 patients had non-definitive hemorrhage patterns, which were bewildered for us to determine the ruptured aneurysms. Fusion of SAH data and CTA data was performed to demonstrate the spatial relationship between the SAH with each aneurysm by using the 3D Slicer software. For the patients with definitive bleed patterns, all of the suspected ruptured aneurysms were confirmed to be accurate according to the surgical records. Interestingly, the suspected rupture sources were correct in 14 of 16 patients with non-definitive hemorrhage patterns. For all 52 patients with multiple intracranial aneurysms, the ruptured aneurysms were identified in 50 cases (96.2%). In conclusion, fusion of SAH data and CTA data can precisely demonstrate the spatial relationship between the SAH with each aneurysm, which is helpful to determine the ruptured aneurysm in patients with multiple intracranial aneurysms.

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Acknowledgments

We are grateful to Dr. Xiaolei Chen, Xinghua Xu, and Zhichao Gan for their help of 3D Slicer software technical assistance.

Funding

The study was supported by the National Natural Science Foundation of China (grant number 81402455).

Author information

Author notes

  1. Anhui Yao and Liyun Jia contributed equally to this work.

Authors and Affiliations

  1. Department of Neurosurgery, Chinese PLA General Hospital, Beijing, China

    Anhui Yao, Benhan Wang, Jiashu Zhang, Zhe Xue, Kai Zhao, Yue Zhao, Na You, Jun Zhang & Bainan Xu

  2. Department of Neurosurgery, the 988 Hospital of PLA, Zhengzhou, Henan Province, China

    Anhui Yao

  3. Department of Medical Genetics & Cell Biology, School of Basic Medical Sciences, Zhengzhou University, Zhengzhou, Henan Province, China

    Liyun Jia

  4. Department of Medical Imaging, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan Province, China

    Jun Li

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  1. Anhui Yao
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Correspondence to Jun Zhang or Bainan Xu.

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Statement of ethics

This work was conducted ethically in accordance with the World Medical Association Declaration of Helsinki. Institutional Review Board (IRB) approval was obtained from Chinese General Hospital of PLA. Informed consent was waived by the IRB as this study was comprised of retrospective medical chart review and analysis of existing data.

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Yao, A., Jia, L., Li, J. et al. Fusion of subarachnoid hemorrhage data and computed tomography angiography data is helpful to identify the rupture source in patients with multiple intracranial aneurysms. Neurosurg Rev 44, 1411–1416 (2021). https://doi.org/10.1007/s10143-019-01221-1

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