Top

Neuroradiology

Published in:

01-02-2015 | Diagnostic Neuroradiology

Potential of 80-kV high-resolution cone-beam CT imaging combined with an optimized protocol for neurological surgery

Authors: Seisaku Kanayama, Takayuki Hara, Yusuke Hamada, Yuji Matsumaru

Published in: Neuroradiology | Issue 2/2015

Abstract

Introduction

With the development of computed tomography (CT) and magnetic resonance imaging (MRI), the use of conventional X-ray angiography including digital subtraction angiography (DSA) for diagnosis has decreased, as it is an invasive technique with a risk of neurological complications. However, X-ray angiography imaging technologies have progressed markedly, along with the development of endovascular treatments. A newly developed angiography technique using cone-beam CT (CBCT) technology provides higher spatial resolution than conventional CT. Herein, we describe the potential of this technology for neurosurgical operations with reference to clinical cases.

Methods

Two hundred twenty-five patients who received 80-kV high-resolution CBCT from July 2011 to June 2014 for preoperative examinations were included in this study. For pathognomonical cases, images were taken with suitable reconstruction modes and contrast protocols. Cases were compared with intraoperative findings or images from other modalities.

Results

We observed the following pathognomonical types: (1) imaging of the distal dural ring (DDR) and the surrounding structure for paraclinoid aneurysms, (2) imaging of thin blood vessels, and (3) imaging of both brain tumors and their surrounding anatomy. Our devised 80-kV high-resolution CBCT imaging system provided clear visualization of detailed anatomy when compared with other modalities in almost all cases. Only two cases provided poor visualization due to movement artifact.

Conclusion

Eighty-kilovolt high-resolution CBCT has the potential to provide detailed anatomy for neurosurgical operations when utilizing suitable modes and contrast protocols.

Vertinsky AT, Schwartz NE, Fischbein NJ, Rosenberg J, Albers GW, Zaharchuk G (2008) Comparison of multidetector CT angiography and MR imaging of cervical artery dissection. AJNR Am J Neuroradiol 29:1753–1760. doi:10.3174/ajnr.A1189 CrossRefPubMed

Tomandl BF, Klotz E, Handschu R, Stemper B, Reinhardt F, Huk WJ, Eberhardt KE, Fateh-Moghadam S (2003) Comprehensive imaging of ischemic stroke with multisection CT. Radiographics 23:565–592. doi:10.1148/rg.233025036 CrossRefPubMed

Mnyusiwalla A, Aviv RI, Symons SP (2009) Radiation dose from multidetector row CT imaging for acute stroke. Neuroradiology 51:635–640. doi:10.1007/s00234-009-0543-6 CrossRefPubMed

Miley JT, Taylor RA, Janardhan V, Tummala R, Lanzino G, Qureshi AI (2008) The value of computed tomography angiography in determining treatment allocation for aneurysmal subarachnoid hemorrhage. Neurocrit Care 9:300–306. doi:10.1007/s12028-008-9109-4 CrossRefPubMed

Akpek S, Brunner T, Benndorf G, Strother C (2005) Three-dimensional imaging and cone beam volume CT in C-arm angiography with flat panel detector. Diagn Interv Radiol 11:10–13PubMed

Mordasini P, Al-Senani F, Gralla J, Do D-D, Brekenfeld C, Schroth G (2009) The use of flat panel angioCT (DynaCT) for navigation through a deformed and fractured carotid stent. Neuroradiology 52:629–632. doi:10.1007/s00234-009-0556-1 CrossRefPubMed

Soderman M, Babic D, Holmin S, Andersson T (2008) Brain imaging with a flat detector C-arm: technique and clinical interest of XperCT. Neuroradiology 50:863–868. doi:10.1007/s00234-008-0419-1 CrossRefPubMed

Patel NV, Gounis MJ, Wakhloo AK, Noordhoek N, Blijd J, Babic D, Takhtani D, Lee SK, Norbash A (2011) Contrast-enhanced angiographic cone-beam CT of cerebrovascular stents: experimental optimization and clinical application. AJNR Am J Neuroradiol 32:137–144. doi:10.3174/ajnr.A2239 PubMed

Blanc R, Pistocchi S, Babic D, Bartolini B, Obadia M, Alamowitch S, Piotin M (2012) Intravenous flat-detector CT angiography in acute ischemic stroke management. Neuroradiology 54:383–391. doi:10.1007/s00234-011-0893-8 CrossRefPubMed

10.

Caroff J, Mihalea C, Neki H, Ruijters D, Ikka L, Benachour N, Moret J, Spelle L (2014) Role of C-Arm VasoCT in the Use of endovascular WEB flow disruption in intracranial aneurysm treatment. AJNR Am J Neuroradiol. doi:10.3174/ajnr.A3860 PubMed

11.

Kizilkilic O, Kocer N, Metaxas GE, Babic D, Homan R, Islak C (2012) Utility of VasoCT in the treatment of intracranial aneurysm with flow-diverter stents. J Neurosurg 117:45–49. doi:10.3171/2012.4.jns111660 CrossRefPubMed

12.

Oikawa S, Kyoshima K, Kobayashi S (1998) Surgical anatomy of the juxta-dural ring area. J Neurosurg 89:250–254. doi:10.3171/jns.1998.89.2.0250 CrossRefPubMed

13.

Matsumura Y, Nagashima M (1999) Anatomical variations in the origin of the human ophthalmic artery with special reference to the cavernous sinus and surrounding meninges. Cells Tissues Organs 164:112–121CrossRefPubMed

14.

Hashimoto K, Nozaki K, Hashimoto N (2006) Optic strut as a radiographic landmark in evaluating neck location of a paraclinoid aneurysm. Neurosurgery 59:880–887. doi:10.1227/01.neu.0000232664.02190.e1 CrossRefPubMed

15.

Murayama Y, Sakurama K, Satoh K, Nagahiro S (2001) Identification of the carotid artery dural ring by using three-dimensional computerized tomography angiography. Technical note. J Neurosurg 95:533–536. doi:10.3171/jns.2001.95.3.0533 CrossRefPubMed

16.

Watanabe Y, Makidono A, Nakamura M, Saida Y (2011) 3D MR cisternography to identify distal dural rings: comparison of 3D-CISS and 3D-SPACE sequences. Magn Reson Med Sci 10:29–32CrossRefPubMed

17.

Watanabe Y, Nakazawa T, Yamada N, Higashi M, Hishikawa T, Miyamoto S, Naito H (2009) Identification of the distal dural ring with use of fusion images with 3D-MR cisternography and MR angiography: application to paraclinoid aneurysms. Am J Neuroradiol 30:845–850. doi:10.3174/ajnr.A1440 CrossRefPubMed

18.

Tsuboi T, Tokunaga K, Shingo T, Itoh T, Mandai S, Kinugasa K, Date I (2007) Differentiation between intradural and extradural locations of juxta-dural ring aneurysms by using contrast-enhanced 3-dimensional time-of-flight magnetic resonance angiography. Surg Neurol 67:381–387. doi:10.1016/j.surneu.2006.08.006 CrossRefPubMed

19.

Hirai T, Kai Y, Morioka M, Yano S, Kitajima M, Fukuoka H, Sasao A, Murakami R, Nakayama Y, Awai K, Toya R, Akter M, Korogi Y, Kuratsu J, Yamashita Y (2008) Differentiation between paraclinoid and cavernous sinus aneurysms with contrast-enhanced 3D constructive interference in steady- state MR imaging. Am J Neuroradiol 29:130–133. doi:10.3174/ajnr.A0756 CrossRefPubMed

20.

Thines L, Lee SK, Dehdashti AR, Agid R, Willinsky RA, Wallace CM, Terbrugge KG (2009) Direct imaging of the distal dural ring and paraclinoid internal carotid artery aneurysms with high-resolution T2 turbo-spin echo technique at 3-T magnetic resonance imaging. Neurosurgery 64:1059–1064. doi:10.1227/01.neu.0000343523.67272.34 CrossRefPubMed

21.

Tanriover N, Rhoton AL Jr, Kawashima M, Ulm AJ, Yasuda A (2004) Microsurgical anatomy of the insula and the sylvian fissure. J Neurosurg 100:891–922. doi:10.3171/jns.2004.100.5.0891 CrossRefPubMed

22.

Suzuki Y, Matsumoto K (2000) Variations of the superficial middle cerebral vein: classification using three-dimensional CT angiography. AJNR Am J Neuroradiol 21:932–938PubMed

Title: Potential of 80-kV high-resolution cone-beam CT imaging combined with an optimized protocol for neurological surgery
Authors: Seisaku Kanayama
Takayuki Hara
Yusuke Hamada
Yuji Matsumaru
Publication date: 01-02-2015
Publisher: Springer Berlin Heidelberg
Published in: Neuroradiology / Issue 2/2015
Print ISSN: 0028-3940
Electronic ISSN: 1432-1920
DOI: https://doi.org/10.1007/s00234-014-1447-7

At a glance: The STEP trials

Springer Medicine

Potential of 80-kV high-resolution cone-beam CT imaging combined with an optimized protocol for neurological surgery

Abstract

Introduction

Methods

Results

Conclusion

At a glance: The STEP trials

Springer Medicine

Abstract

Introduction

Methods

Results

Conclusion

Please log in to get access to this content

Other articles of this Issue 2/2015

Administration of eptifibatide during endovascular treatment of ruptured cerebral aneurysms reduces the rate of thromboembolic events

Microembolic signal monitoring and the prediction of thromboembolic events following coil embolization of unruptured intracranial aneurysms: diffusion-weighted imaging correlation

Susceptibility-weighted imaging of the venous networks around the brain stem

Cranial Doppler ultrasound in Vein of Galen malformation

Infarct volume predicts critical care needs in stroke patients treated with intravenous thrombolysis

Whole-brain 320-detector row dynamic volume CT perfusion detected crossed cerebellar diaschisis after spontaneous intracerebral hemorrhage