Advertisement

Intravenous Flat Panel Detector CT Angiography for the Assessment of Intracranial Arteries

  • Jin Pyeong Jeon
  • Seung Hun SheenEmail author

Abstract

Atherosclerotic intracranial arterial stenosis is an important cause of ischemic stroke [1, 2]. Main predictor of vulnerable intracranial stenosis includes high severity (>70 % luminal narrowing), extent of disease (number of intracranial stenosis), disease progression, and presence of symptomaticity [2]. Although cerebral angiography is the most accurate method for estimating stenosis, procedural complications and invasive nature can be concerns. Accordingly, noninvasive methods such as magnetic resonance angiography (MRA), computed tomography angiography (CTA), and transcranial Doppler (TCD) have been used alternatively.

Keywords

Magnetic Resonance Angiography Cerebral Blood Volume High Dynamic Range Single Acquisition Intracranial Stenosis 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Notes

Acknowledgement

We would like to thank Sung-Eun Kim and YoungHo Kim (Siemens) for help with the data collection and valuable contribution to the image preparation.

References

  1. 1.
    Wong KS, Li H. Long-term mortality and recurrent stroke risk among Chinese stroke patients with predominant intracranial atherosclerosis. Stroke. 2003;34:2361–6.CrossRefPubMedGoogle Scholar
  2. 2.
    Arenillas JF. Intracranial atherosclerosis: current concepts. Stroke. 2011;42:S20–3.CrossRefPubMedGoogle Scholar
  3. 3.
    Patel NV, Gounis MJ, Wakhloo AK, Noordhoek N, Blijd J, Babic D, et al. Contrast-enhanced angiographic cone-beam CT of cerebrovascular stents: Experimental optimization and clinical application. AJNR Am J Neuroradiol. 2011;32:137–44.PubMedGoogle Scholar
  4. 4.
    Struffert T, Deuerling-Zheng Y, Engelhorn T, Kloska S, Golitz P, Kohrmann M, et al. Feasibility of cerebral blood volume mapping by flat panel detector CT in the angiography suite: first experience in patients with acute middle cerebral artery occlusions. AJNR Am J Neuroradiol. 2012;33:618–25.CrossRefPubMedGoogle Scholar
  5. 5.
    Ebrahimi N, Claus B, Lee CY, Biondi A, Benndorf G. Stent conformity in curved vascular models with simulated aneurysm necks using flat-panel ct: an in vitro study. AJNR Am J Neuroradiol. 2007;28:823–9.PubMedGoogle Scholar
  6. 6.
    Buhk JH, Kallenberg K, Mohr A, Dechent P, Knauth M. Evaluation of angiographic computed tomography in the follow-up after endovascular treatment of cerebral aneurysms–a comparative study with DSA and TOF-MRA. Eur Radiol. 2009;19:430–6.CrossRefPubMedGoogle Scholar
  7. 7.
    Psychogios MN, Buhk JH, Schramm P, Xyda A, Mohr A, Knauth M. Feasibility of angiographic CT in peri-interventional diagnostic imaging: a comparative study with multidetector CT. AJNR Am J Neuroradiol. 2010;31:1226–31.CrossRefPubMedGoogle Scholar
  8. 8.
    Struffert T, Deuerling-Zheng Y, Kloska S, Engelhorn T, Strother CM, Kalender WA, et al. Flat detector ct in the evaluation of brain parenchyma, intracranial vasculature, and cerebral blood volume: a pilot study in patients with acute symptoms of cerebral ischemia. AJNR Am J Neuroradiol. 2010;31:1462–9.CrossRefPubMedGoogle Scholar
  9. 9.
    Kalender WA, Kyriakou Y. Flat-detector computed tomography (FD-CT). Eur Radiol. 2007;17:2767–79.CrossRefPubMedGoogle Scholar
  10. 10.
    Spahn M. Flat detectors and their clinical applications. Eur Radiol. 2005;15:1934–47.CrossRefPubMedGoogle Scholar
  11. 11.
    Stone MF, Zhao W, Jacak BV, O’Connor P, Yu B, Rehak P. The x-ray sensitivity of amorphous selenium for mammography. Med Phys. 2002;29:319–24.CrossRefPubMedGoogle Scholar
  12. 12.
    White PM, Gilmour JN, Weir NW, Innes B, Sellar RJ. AngioCT in the management of neurointerventional patients: a prospective, consecutive series with associated dosimetry and resolution data. Neuroradiology. 2008;50:321–30.CrossRefPubMedGoogle Scholar
  13. 13.
    Jeon JS, Sheen SH, Hwang GJ, Kim HC, Kwon BJ. Feasibility of intravenous flat panel detector ct angiography for intracranial arterial stenosis. AJNR Am J Neuroradiol. 2013;34:129–34.CrossRefPubMedGoogle Scholar
  14. 14.
    Kamran M, Nagaraja S, Byrne JV. C-arm flat detector computed tomography: the technique and its applications in interventional neuro-radiology. Neuroradiology. 2010;52:319–27.CrossRefPubMedGoogle Scholar
  15. 15.
    Jou LD, Mohamed A, Lee DH, Mawad ME. 3D rotational digital subtraction angiography may underestimate intracranial aneurysms: findings from two basilar aneurysms. AJNR Am J Neuroradiol. 2007;28:1690–2.CrossRefPubMedGoogle Scholar
  16. 16.
    Blanc R, Pistocchi S, Babic D, Bartolini B, Obadia M, Alamowitch S, et al. Intravenous flat-detector CT angiography in acute ischemic stroke management. Neuroradiology. 2012;54:383–91.CrossRefPubMedGoogle Scholar
  17. 17.
    Nonaka T, Oka S, Miyata K, Mikami T, Koyanagi I, Houkin K, et al. Prediction of prolonged postprocedural hypotension after carotid artery stenting. Neurosurgery. 2005;57:472–7. discussion 472–477.CrossRefPubMedGoogle Scholar
  18. 18.
    Benndorf G, Strother CM, Claus B, Naeini R, Morsi H, Klucznik R, et al. Angiographic CT in cerebrovascular stenting. AJNR Am J Neuroradiol. 2005;26:1813–8.PubMedGoogle Scholar
  19. 19.
    Jeon JS, Sheen SH, Kim HC. Intravenous flat-detector computed tomography angiography for high-grade carotid stenosis. J Comput Assist Tomogr. 2013;37:242–6.CrossRefPubMedGoogle Scholar
  20. 20.
    Riedel CH, Jensen U, Rohr A, Tietke M, Alfke K, Ulmer S, et al. Assessment of thrombus in acute middle cerebral artery occlusion using thin-slice nonenhanced computed tomography reconstructions. Stroke. 2010;41:1659–64.CrossRefPubMedGoogle Scholar
  21. 21.
    Daly MJ, Siewerdsen JH, Moseley DJ, Jaffray DA, Irish JC. Intraoperative cone-beam CT for guidance of head and neck surgery: assessment of dose and image quality using a c-arm prototype. Med Phys. 2006;33:3767–80.CrossRefPubMedGoogle Scholar
  22. 22.
    Furlan A, Higashida R, Wechsler L, Gent M, Rowley H, Kase C, et al. Intra-arterial prourokinase for acute ischemic stroke. The proact II study: a randomized controlled trial. Prolyse in acute cerebral thromboembolism. JAMA. 1999;282:2003–11.CrossRefPubMedGoogle Scholar
  23. 23.
    del Zoppo GJ, Higashida RT, Furlan AJ, Pessin MS, Rowley HA, Gent M. Proact: a phase II randomized trial of recombinant pro-urokinase by direct arterial delivery in acute middle cerebral artery stroke. Proact investigators. Prolyse in acute cerebral thromboembolism. Stroke. 1998;29:4–11.CrossRefPubMedGoogle Scholar
  24. 24.
    Jansen O, Schellinger P, Fiebach J, Hacke W, Sartor K. Early recanalisation in acute ischaemic stroke saves tissue at risk defined by MRI. Lancet. 1999;353:2036–7.CrossRefPubMedGoogle Scholar
  25. 25.
    Akins PT, Amar AP, Pakbaz RS, Fields JD, Investigators S. Complications of endovascular treatment for acute stroke in the swift trial with solitaire and merci devices. AJNR Am J Neuroradiol. 2014;35:524–8.CrossRefPubMedGoogle Scholar
  26. 26.
    Heran NS, Song JK, Namba K, Smith W, Niimi Y, Berenstein A. The utility of dynact in neuroendovascular procedures. AJNR Am J Neuroradiol. 2006;27:330–2.PubMedGoogle Scholar
  27. 27.
    Buhk JH, Lingor P, Knauth M. Angiographic CT with intravenous administration of contrast medium is a noninvasive option for follow-up after intracranial stenting. Neuroradiology. 2008;50:349–54.PubMedCentralCrossRefPubMedGoogle Scholar
  28. 28.
    Suh DC, Kim JK, Choi JW, Choi BS, Pyun HW, Choi YJ, et al. Intracranial stenting of severe symptomatic intracranial stenosis: results of 100 consecutive patients. AJNR Am J Neuroradiol. 2008;29:781–5.CrossRefPubMedGoogle Scholar
  29. 29.
    Bley T, Strother CM, Pulfer K, Royalty K, Zellerhoff M, Deuerling-Zheng Y, et al. C-arm CT measurement of cerebral blood volume in ischemic stroke: an experimental study in canines. AJNR Am J Neuroradiol. 2010;31:536–40.CrossRefPubMedGoogle Scholar
  30. 30.
    Royalty K, Manhart M, Pulfer K, Deuerling-Zheng Y, Strother C, Fieselmann A, et al. C-arm CT measurement of cerebral blood volume and cerebral blood flow using a novel high-speed acquisition and a single intravenous contrast injection. AJNR Am J Neuroradiol. 2013;34:2131–8.CrossRefPubMedGoogle Scholar
  31. 31.
    Wintermark M, Smith WS, Ko NU, Quist M, Schnyder P, Dillon WP. Dynamic perfusion CT: optimizing the temporal resolution and contrast volume for calculation of perfusion ct parameters in stroke patients. AJNR Am J Neuroradiol. 2004;25:720–9.PubMedGoogle Scholar
  32. 32.
    Psychogios MN, Wachter D, Mohr A, Schramm P, Frolich AM, Jung K, et al. Feasibility of flat panel angiographic ct after intravenous contrast agent application in the postoperative evaluation of patients with clipped aneurysms. AJNR Am J Neuroradiol. 2011;32:1956–62.CrossRefPubMedGoogle Scholar
  33. 33.
    Richter G, Engelhorn T, Struffert T, Doelken M, Ganslandt O, Hornegger J, et al. Flat panel detector angiographic CT for stent-assisted coil embolization of broad-based cerebral aneurysms. AJNR Am J Neuroradiol. 2007;28:1902–8.CrossRefPubMedGoogle Scholar
  34. 34.
    Jeon JP, Sheen SH, Cho YJ. Intravenous flat-detector computed tomography angiography for symptomatic cerebral vasospasm following aneurysmal subarachnoid hemorrhage. Scientific World Journal. 2014:315960.Google Scholar
  35. 35.
    Bai M, Liu B, Mu H, Liu X, Jiang Y. The comparison of radiation dose between c-arm flat-detector CT (dynact) and multi-slice CT (MSCT): a phantom study. Eur J Radiol. 2012;81:3577–80.CrossRefPubMedGoogle Scholar
  36. 36.
    Prell D, Kyriakou Y, Struffert T, Dorfler A, Kalender WA. Metal artifact reduction for clipping and coiling in interventional c-arm CT. AJNR Am J Neuroradiol. 2010;31:634–9.CrossRefPubMedGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2015

Authors and Affiliations

  1. 1.Department of NeurosurgeryHallym University College of MedicineChuncheonSouth Korea
  2. 2.Department of NeurosurgeryBundang Jesaeng HospitalSeoulSouth Korea

Personalised recommendations