Rotational C-Arm-Based CT in Diagnostic and Interventional Neuroradiology

Abstract

C-arm-mounted flat detectors capable of volume scanning allow for CT-like imaging (FD-CT) in the angiography suite or in the operating room, respectively. The acquisition of 3D angiographies was introduced in the era of image intensifier Carms. Several advancements in research and development concerning flat detectors have allowed imaging that provides real soft tissue resolution using rotating C-arms for the first time. This CT option of flat detector-equipped C-arms offers a large number of potential applications. The high spatial resolution of 3D angiography allows precise visualization of vascular pathologies, such as cerebral aneurysms and arteriovenous malformations. In addition, the soft tissue imaging option of FD-CT enables the neurointerventionalist to detect space-occupying intracranial lesions, in the first instance acute hemorrhage in patients suffering from vascular diseases. This allows to prove or to exclude bleeding or rebleeding in patients undergoing endovascular interventions without patient transfer to conventional CT. The high spatial resolution of FD-CT enables high quality imaging of small intracranial devices, such as microstents or cochlear implants. An additional, three-dimensional, multiplanar FD-CT of the spine may be helpful in vertebroplasties or kyphoplasties and for mylography. In the future, FD-CT data may possibly become important for procedures performed with 3D navigation.