Abstract
Introduction
Contrast-enhanced cone-beam computed tomography (CBCT) has been introduced and accepted as a useful technique to evaluate delicate vascular anatomy and neurovascular stents. Current protocol for CBCT requires quantitative dilution of contrast medium to obtain adequate quality images. Here, we introduce simple methods to obtain contrast-enhanced CBCT without quantitative contrast dilution.
Methods
A simple experiment was performed to estimate the change in flow rate in the internal carotid artery during the procedure. Transcranial doppler (TCD) was used to evaluate the velocity change before and after catheterization and fluid infusion. In addition, 0.3 cm3/s (n = 3) and 0.2 cm3/s (n = 7) contrast infusions were injected and followed by saline flushes using a 300 mmHg pressure bag to evaluate neurovascular stent and host arteries.
Results
Flow velocities changed −15 ± 6.8 % and +17 ± 5.5 % from baseline during catheterization and guiding catheter flushing with a 300 mmHg pressure bag, respectively. Evaluation of the stents and vascular structure was feasible using this technique in all patients. Quality assessment showed that the 0.2 cm3/s contrast infusion protocol was better for evaluating the stent and host artery.
Conclusion
Contrast-enhanced CBCT can be performed without quantitative contrast dilution. Adequate contrast dilution can be achieved with a small saline flush and normal blood flow.
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Abbreviations
- CBCT:
-
Cone-beam CT
- CM:
-
Contrast medium
- mFV:
-
Mean flow velocity
- TCD:
-
Transcranial Doppler
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We declare that all human and animal studies have been approved by the local Ethics Committee and have therefore been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments. We declare that all patients gave informed consent prior to inclusion in this study.
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Jo, K.I., Kim, S.R., Choi, J.H. et al. Contrast-enhanced angiographic cone-beam computed tomography without pre-diluted contrast medium. Neuroradiology 57, 1121–1126 (2015). https://doi.org/10.1007/s00234-015-1570-0
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DOI: https://doi.org/10.1007/s00234-015-1570-0