Purpose: Diagnostic and neurosurgical procedures require the precise localization of small intracranial arteries, but this may be difficult using conventional computed tomography angiography (CTA). This study was conducted to evaluate the quality of CTA images acquired using a prototype ultra-high-resolution computed tomography (U-HRCT) system compared with those acquired using a conventional computed tomography (C-CT) system. Materials and methods: From July through September 2015, 10 adult patients (6 women and 4 men) previously scanned by C-CT were examined using U-HRCT to locate and assess cerebral aneurysms. The bilateral ophthalmic artery (Opth A), anterior choroidal artery (Acho A), and thalamoperforating arteries (TPAs) were visually evaluated in randomly presented CTA images. Images were graded on a 5-point scale, and differences in scores between U-HRCT and C-CT were evaluated by the Wilcoxon signed-rank test. A p value < 0.05 was considered statistically significant. Results: Visual evaluation scores for images of the Opth A, Acho A, and TPAs were significantly higher for U-HRCT than for C-CT. U-HRCT images achieved good visualization (score > 3) for C-CT images with poor visualization (score < 3) in 66.7–100% of all the small arteries. Conclusion: U-HRCT is superior to C-CT for detecting and evaluating clinically significant small intracranial arteries.
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