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Dynamic 3D-CT Angiography

M. Matsumotoa, N. Kodamaa, Y. Endoa, J. Sakumaa, Ky. Suzukia, T. Sasakia, K. Murakamib, Ke. Suzukib, T. Katakurab and F. Shishidob

a Department of Neurosurgery, Fukushima Medical University, Fukushima, Japan
b Radiology, Fukushima Medical University, Fukushima, Japan


Figure 1
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  		Fig 1. A 52-year-old woman with a sphenoid ridge meningioma (case 3). A, Plain CT shows a mass with calcification in the left frontotemporal region.

B, Coronal contrast-enhanced T1-weighted image reveals a homogenous enhanced mass in the left middle fossa.

C and D, A left external carotid artery angiogram, lateral views of the early (C) and late (D) phase, reveals a tumor stain fed by the middle meningeal artery.

E, d3D-CTA (superior view). d3D-CT angiographs obtained at 10, 13, 15, 16, 18, and 20 seconds after contrast injection are shown. The tumor stain is first demonstrated in the arterial phase (at 15 seconds). d3D-CTA indicates that the blood supply to the tumor is from the sphenoid ridge. Calcifications within the tumor are shown at 10 seconds. ICA, left internal carotid artery; BA, basilar artery; SPV, sphenoparietal vein.


Figure 2
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  		Fig 2. A 61-year-old woman with an arteriovenous malformation (AVM) in the left frontal lobe (case 8). A and B, Left internal carotid artery angiogram, lateral views of the arterial (A) and venous (B) phase, reveals an AVM fed by branches of the anterior and middle cerebral arteries; drainage is into the frontal ascending vein.

C, d3D-CTA (inferior view) obtained at 0.5-second intervals after contrast injection. The anterior cerebral artery (feeder, arrow) is demonstrated at 10 seconds; the frontal ascending vein (drainer, arrowhead) is shown in the early arterial phase (at 13 and 13.5 seconds). The d3D-CTA scans demonstrate the hemodynamics of the AVM.

D, d3D-CTA (superior view) obtained at 13.5, 15, 16, and 20 seconds after contrast injection. The feeding arteries, nidus, and drainer are visualized in the arterial phase (at 13.5 and 15 seconds). MCA, branch of the middle cerebral artery; ACA, branches of the anterior cerebral artery; *, varices.

E, d3D-CTA (left lateral view) obtained at 13.5, 15, 16, and 20 seconds after contrast injection. In the early arterial phase (at 13.5 seconds) the feeder, a branch of the anterior cerebral artery (arrow), and the nidus are demonstrated. The arterial phase (at 16 seconds) revealed a drainer (arrowheads), indicating that there is an arteriovenous shunt. d3D-CTA provided information on the hemodynamics and the 3D vascular structures of the AVM.


Figure 3
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  		Fig 3. A 75-year-old woman with occlusion of the right cervical internal carotid artery (case 12). A, Cervical 3D-CTA showing occlusion of the right internal carotid artery (arrow). Right lateral (left) and left lateral (right) views of the right cervical vessels are shown. CCA, common carotid artery.

B, d3D-CTA (anterosuperior view). 3D-CTA scans were obtained at 12, 12.5, 13, 13.5, 14, and 14.5 seconds after contrast injection. The right middle cerebral artery (MCA, arrowheads) is visualized later (at 13 or 13.5 seconds) than the left MCA (arrows), which appeared at 12.5 seconds. d3D-CTA demonstrates the right MCA with a 0.5- and 1-second filling delay compared with the left MCA. The smaller caliber of the right compared with the left MCA indicates that the blood flow volume in the right MCA is smaller than in the left MCA. Cal, calcification.

C, Functional maps of cerebral blood flow (CBF), cerebral blood volume (CBV), and mean transit time (MTT) produced from d3D-CTA data. The maps showed no significant difference between the 2 hemispheres.





Copyright © 2008 by the American Society of Neuroradiology. Print ISSN: 0195-6108 Online ISSN: 1936-959X