Application of Spinal Subtraction and Bone Background Fusion CTA in the Accurate Diagnosis and Evaluation of Spinal Vascular Malformations

• DOI: 10.3174/ajnr.a8112
• Publication Date: 2024-02-15T20:05:18Z
• Authors: Xuehan Hu; Zhidong Yuan; Kaiyin Liang; Min Chen; Zhen Zhang; Hairong Zheng; Guanxun Cheng
• Keywords: Subtraction; Vascular malformation; Digital subtraction angiography

<h3>BACKGROUND AND PURPOSE:</h3> Accurate pretreatment diagnosis and assessment of spinal vascular malformations using CTA are crucial for patient prognosis, but the postprocessing reconstruction may not be able to fully depict lesions due complexity inherent in anatomy. Our purpose was explore application value subtraction bone background fusion (SSBBF-CTA) technique precisely depicting localizing malformation lesions. <h3>MATERIALS METHODS:</h3> In this retrospective study, patients (between November 2017 2022) with symptoms similar those were divided into diseased (group A) nondiseased B) groups. All underwent Siemens dual-source CT. Multiplanar reconstruction; routine subtraction, SSBBF-CTA images obtained snygo.via ADW4.6 workstations. Multiple observers researched following 3 aspects: 1) preliminary screening capability original multiplanar CTA, 2) accuracy stability technique, 3) diagnostic evaluation types images. Diagnostic performance analyzed receiver operating characteristic analysis, while reader or image differences Wilcoxon signed-rank test Kruskal-Wallis rank sum test. <h3>RESULTS:</h3> Forty-nine (groups A B: 22 27 patients; mean ages, 44.0 [SD, 14.3] years 44.6 [SD,15.2] years; 13 16 men) evaluated. Junior physicians showed lower sensitivity (85.7% 77.3%) than senior (93.9% 90.9%, 98% 95.5%). Short-term trained juniors achieved that experienced (<i>P</i> &gt; .05). terms visualization localization (nidus/fistula, feeding artery, drainage vein), both outperformed = .000). Compared reconstruction, allowed less achieve superior capabilities (comparable radiologists) more rapidly &lt; <h3>CONCLUSIONS:</h3> The exhibited excellent reproducibility enabled accurate high efficiency, particularly junior radiologists.