[Angiography with spiral computerized tomography in the study of aneurysms of the visceral arteries. Techniques and results].

INTRODUCTION: The aneurysms of visceral vessels are characterized by few or no symptoms and the diagnosis is often occasional. We investigated the usefulness of CT angiography in the diagnosis and preoperative assessment of this condition. MATERIALS AND METHODS: From January 1993 to March 1998, twenty-five patients (aged 32-69 years) with 28 aneurysms underwent CT angiography before and after contrast agent injection to study lesion number, site, size, neck, intraluminal thrombosis and wall calcifications. Data from axial images were postprocessed on an external work-station to obtain CT angiograms. CT angiography findings were analyzed with a double blinded method by 2 radiologists comparing CT angiography with digital subtraction angiography images and evaluating the information obtained from Multiplanar (MPR), Maximum Intensity Projection (MIP) and Shaded Surface Display (SSD) reconstructions. Surgical findings were available for 10 patients. RESULTS: There was complete agreement between CT angiography and digital subtraction angiography in the identification of all lesions; the correlation rate was 94.42% for lesion location, 89.28% for lesion size, 85.71% for detection of endoluminal thrombosis and 82.14% for identification of wall calcifications. Axial and MPR images were useful in the assessment of ali parameters, while MIP images accurately demonstrated wall calcifications and the lesion relationships with adjacent structures. No additional information was obtained from SSD reconstructions. CONCLUSIONS: In our experience CT angiography can replace digital subtraction angiography in the diagnosis and preoperative work-up of visceral vessels aneurysms. CT angiography was superior to digital angiography in the evaluation of the lesion exact dimensions in cases with large thrombotic component and diffuse wall calcifications.