AJDRAJNR - American Journal of Neuroradiology

Published ahead of print on February 12, 2009
doi: 10.3174/ajnr.A1438

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Technical Note
INTERVENTIONAL

Multi-Detector Row CT Angiography with Direct Intra-Arterial Contrast Injection for the Evaluation of Neurovascular Disease: Technique, Applications, and Initial Experience

D. Gandhia, A. Pandeyc, S.A. Ansarib, J.J. Gemmeteb, B.G. Thompson, Jrc and S.K. Mukherjib

a Division of Interventional Neuroradiology, Department of Radiology, Russell H. Morgan Department of Radiology, Johns Hopkins Medical Institutions, Baltimore, Md
b Division of Interventional and Diagnostic Neuroradiology, Department of Radiology
c Department of Neurosurgery, University of Michigan Health System, Ann Arbor, Mich

Please address correspondence to Dheeraj Gandhi, MD, Division of Interventional Neuroradiology, Russell H. Morgan Department of Radiology, 600 N. Wolfe St, Radiology B-100, Baltimore, MD 21287; e-mail: dgandhi2{at}jhmi.edu

SUMMARY: The purpose of this study was to evaluate the usefulness of 64-section multi-detector row CT angiography (CTA) with direct intra-arterial contrast injection (IA-CTA) for the evaluation of neurovascular disease. This technique was used in 11 patients at our institution. All studies were technically successful, and there were no complications. Small vascular malformations were mapped easily on high-resolution IA-CTA images, enabling microsurgical resection or stereotactic radiosurgery. In a similar fashion, additional morphologic features were revealed on IA-CTA images not seen on standard 2D and 3D digital subtraction angiography. Of 11 patients undergoing IA-CTA, 7 patients had further anatomic clarity of the small arteriovenous fistula/malformation and 4 patients had changes in the treatment plan on the basis of the IA-CTA findings.