Vasospasm after subarachnoid hemorrhage: a 3D rotational angiography study.

BACKGROUND AND PURPOSE: the purpose of this study was to investigate the clinical value of 3D rotational angiography (3DRA) for evaluation of cerebral vasospasm in patients with aneurysmal subarachnoid hemorrhage (SAH) by comparison with 2D digital subtraction angiography (DSA). METHODS: forty-six patients who had undergone 2D DSA and 3DRA for evaluation of cerebral vasospasm following SAH were retrospectively analyzed. 3DRA was routinely performed after standard 2D DSA. 3D volume rendering images were created from 3DRA dataset and compared with DSA for the detection and characterization of vasospasm. RESULTS: Of the 46 patients investigated, 25 had vasospasm on 2D DSA images. No vasospasm was observed in 21 patients with aneurysmal SAH. According to the reference standard of DSA, 46 spastic segments were found in 25 patients with vasospasms. A total of 51 spastic segments were found on 3DRA volume rendering angiograms. The sensitivity, specificity, positive and negative predictive values of 3DRA for detecting vasospasm were 100, 76, 90, 100%, respectively. CONCLUSION: the pseudo-spasm phenomenon was frequently observed on 3DRA volume rendering images. 3DRA was less useful than 2D DSA for evaluation of vasospasm after SAH.