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computed_tomography_angiography

Computed tomography angiography

Computed tomography angiography (CTA) is a computed tomography technique used to visualize artery and veins throughout the body. This ranges from arteries serving the brain to those bringing blood to the lungs, kidneys, arms and legs.

With the development of CTA, MRA and 3D-DSA, more and more patients with intracranial aneurysms have been detected.

Computed tomography angiography is slowly replacing digital subtraction angiography as the first-line technique for the diagnosis and treatment planning of intracranial aneurysms, but digital subtraction angiography is still required in patients with diffuse subarachnoid hemorrhage (SAH) and negative initial computed tomography angiography 1).

Few studies have examined the risk of computed tomography angiography (CTA) during the acute phase of spontaneous intracerebral hemorrhage (ICH), while the benefits of CTA in ICH have been well-documented. The study from Hotta et al., investigated both the benefits of identifying CT angiography spot sign.

see Dynamic computed tomography angiography.

see Three dimensional computed tomography angiography.

see Four dimensional computed tomography angiography.

Subarachnoid hemorrhage

Brain death

Paraclinoid aneurysm

High-resolution thin-cut CTA is a fast and crucial tool for diagnosing paraclinoid aneurysms. The optic strut (OS) serves as an effective landmark in CTA source images for distinguishing between intradural and extradural paraclinoid aneurysms. The distal dural ring (DDR) is supposed to be located 2 mm above the base of the OS in axial planes 2).

Problems

Flat panel detector CT angiography with intravenous contrast agent injection (IV CTA) allows high-resolution imaging of cerebrovascular structures. Artifacts caused by metallic implants like platinum coils or clips lead to degradation of image quality and are a significant problem.

When an intravenous contrast protocol is used, metal artifact reduction (MAR) significantly ameliorates the assessability of brain parenchyma, vessels, and treated aneurysms in patients with intracranial coils or clips 3).

1)
de Oliveira Manoel AL, Mansur A, Murphy A, Turkel-Parrella D, Macdonald M, Macdonald RL, Montanera W, Marotta TR, Bharatha A, Effendi K, Schweizer TA. Aneurysmal subarachnoid haemorrhage from a neuroimaging perspective. Crit Care. 2014 Nov 13;18(6):557. doi: 10.1186/s13054-014-0557-2. Review. PubMed PMID: 25673429; PubMed Central PMCID: PMC4331293.
2)
Liao CH, Lin CJ, Lin CF, Huang HY, Chen MH, Hsu SP, Shih YH. Comparison of the effectiveness of using the optic strut and tuberculum sellae as radiological landmarks in diagnosing paraclinoid aneurysms with CT angiography. J Neurosurg. 2016 Jan 8:1-8. [Epub ahead of print] PubMed PMID: 26745492.
3)
Pjontek R, Önenköprülü B, Scholz B, Kyriakou Y, Schubert GA, Nikoubashman O, Othman A, Wiesmann M, Brockmann MA. Metal artifact reduction for flat panel detector intravenous CT angiography in patients with intracranial metallic implants after endovascular and surgical treatment. J Neurointerv Surg. 2015 Sep 7. pii: neurintsurg-2015-011787. doi: 10.1136/neurintsurg-2015-011787. [Epub ahead of print] PubMed PMID: 26346458.
computed_tomography_angiography.txt · Last modified: 2018/03/05 17:24 by administrador