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Dynamic CT Angiography and CT Perfusion Employing a 320-Detector Row CT

Protocol and Current Clinical Applications

Dynamische CT-Angiographie und CT-Perfusion mit einem 320-Zeilen-CT. Protokoll und aktuelle klinische Anwendungen

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Abstract

The aim of this study is to report the authors’ initial clinical experience of a 320-detector row computed tomography (CT) scanner in cerebrovascular disorders. Volumetric CT using the full 160-mm width of the 320 detector rows enables full brain coverage in a single rotation that allows for combined time-resolved whole-brain perfusion and four-dimensional CT angiography (CTA). The protocol for the combined dynamic CTA and CT perfusion (CTP) is presented, and its potential applications in stroke, stenoocclusive disease, arteriovenous malformations and dural shunts are reviewed based on clinical examples. The combined CTA/CTP data can provide visualization of dynamic flow and perfusion as well as motion of an entire volume at very short time intervals which is of importance in a variety of pathologies with altered cerebral hemodynamics. The broad coverage enabled by 320 detector rows offers z-axis coverage allowing for whole-brain perfusion and subtracted dynamic angiography of the entire intracranial circulation.

Zusammenfassung

Das Ziel der vorliegenden Studie ist es, die eigene klinische Erfahrung mit einem 320-Zeilen-Computertomographen (CT) bei zerebrovaskulären Erkrankungen zu präsentieren. Die Detektorbreite von 16 cm ermöglicht die Erfassung des gesamten Schädels mit nur einer Rotation, ohne dass eine Patienten- oder Gantrybewegung durchgeführt werden muss. Dies ermöglicht zeitaufgelöste CT-Angiographien (CTA) und CT-Perfusion (CTP). In dieser Arbeit wird ein CT-Protokoll präsentiert, mit dem nach nur einer Kontrastmittelapplikation sowohl CTA- als auch CTP-Daten rekonstruiert werden können. Anwendungen für dieses Protokoll sind der akute Schlaganfall, stenookklusive Erkrankungen sowie die prätherapeutische Abklärung und Verlaufskontrolle arteriovenöser Malformationen und Fisteln (sowohl in der Erstdiagnose wie auch bei Verlaufskontrollen). Im Rahmen von Patientenbeschreibungen werden einige der klinischen Applikationen dieses Protokolls vorgestellt. Die kombinierte Akquisition von CTA- und CTP-Daten kann nicht nur die Dynamik der Hirndurchblutung darstellen, sondern ist auch in der Lage, Bewegungen des untersuchten Volumens zu visualisieren. Durch Abbildung des gesamten Hirnvolumens in nur einer Rotation ergibt sich eine Vielzahl von klinischen Applikationen.

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Authors and Affiliations

  1. Division of Neuroradiology, Department of Medical Imaging, University of Toronto, Toronto Western Hospital and Hospital for Sick Children, Toronto, ON, Canada

    Eric J. Salomon, Joe Barfett, Peter W. A. Willems, Sasikhan Geibprasert, Susanna Bacigaluppi & Timo Krings

  2. Division of Neuroradiology, University of Toronto Toronto Western Hospital, UHN, 399 Bathurst St, 3MCL – 429, Toronto, ON, M5T 2S8, Canada

    Timo Krings

Authors
  1. Eric J. Salomon
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  2. Joe Barfett
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  3. Peter W. A. Willems
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  4. Sasikhan Geibprasert
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  5. Susanna Bacigaluppi
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  6. Timo Krings
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Correspondence to Timo Krings.

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Salomon, E.J., Barfett, J., Willems, P.W.A. et al. Dynamic CT Angiography and CT Perfusion Employing a 320-Detector Row CT. Clin Neuroradiol 19, 187–196 (2009). https://doi.org/10.1007/s00062-009-9019-7

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  • DOI: https://doi.org/10.1007/s00062-009-9019-7

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