Advanced cone-beam CT venous angiographic imaging

Visish M. Srinivasan, Gouthami Chintalapani, Edward A.M. Duckworth, Peter Kan

Research output: Contribution to journalArticle

Abstract

OBJECTIVE The evaluation of the venous neurovasculature, especially the dural venous sinuses, is most often performed using MR or CT venography. For further assessment, diagnostic cerebral angiography may be performed. Three-dimensional rotational angiography (3D-RA) can be applied to the venous system, producing 3D rotational venography (3D-RV) and cross-sectional reconstructions, which function as an adjunct to traditional 2D digital subtraction angiography. METHODS After querying the database of Baylor St. Luke's Medical Center in Houston, Texas, the authors reviewed the radiological and clinical data of patients who underwent 3D-RV. This modality was performed based on standard techniques for 3D-RA, with the catheter placed in the internal carotid artery and a longer x-ray delay calculated based on time difference between the early arterial phase and the venous phase. RESULTS Of the 12 cases reviewed, 5 patients had neoplasms invading a venous sinus, 4 patients with idiopathic intracranial hypertension required evaluation of venous sinus stenosis, 2 patients had venous diverticula, and 1 patient had a posterior fossa arachnoid cyst. The x-ray delay ranged from 7 to 10 seconds. The 3D-RV was used both for diagnosis and in treatment planning. CONCLUSIONS Three-dimensional RV and associated cross-sectional reconstructions can be used to assess the cerebral venous vasculature in a manner distinct from established modalities. Three-dimensional RV can be performed with relative ease on widely available biplane equipment, and data can be processed using standard software packages. The authors present the protocol and technique used along with potential applications to venous sinus stenosis, venous diverticula, and tumors invading the venous sinuses.

Original languageEnglish (US)
Pages (from-to)114-120
Number of pages7
JournalJournal of neurosurgery
Volume129
Issue number1
DOIs
StatePublished - Jul 2018
Externally publishedYes

Keywords

  • 3D
  • Angiogram
  • Cone-beam CT
  • Digital subtraction angiography
  • DSA
  • Sinus stenosis
  • Vascular disorders
  • Venous diverticulum

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology

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  • Cite this

    Srinivasan, V. M., Chintalapani, G., Duckworth, E. A. M., & Kan, P. (2018). Advanced cone-beam CT venous angiographic imaging. Journal of neurosurgery, 129(1), 114-120. https://doi.org/10.3171/2017.2.JNS162997