Abstract
Background
Dynamic CT angiography (dCTA) augments traditional CTA with temporal resolution and has been demonstrated to influence operative planning in skull base surgery.
Methods
Three hundred twenty-five dynamic CTA cases from a single institution were reviewed for indication of study, findings, and comparison to other modalities of imaging.
Results
The most frequent application of dCTA was pre-operative surgical planning (59.4%); resection of skull base tumors represented the majority of these pre-operative studies (93.3%). It was also used to evaluate new neurological symptoms (20.9%). Of these, the most common symptoms prompting a dCTA study included headache (22.1%) and visual field deficit (11.8%). The most commonly visualized vascular lesions were partial (22.9%) and complete vascular occlusions (9.0%). Dynamic CTA has also been useful in post-operative imaging for vascular malformations (9.5%) and tumors (2.5%). Finally, dCTA was employed to evaluate ambiguous abnormal findings observed on other imaging modalities (7.7%). Cerebral dCTA ruled out inconclusive abnormal vascular findings visualized on other imaging modalities (64.0%) more frequently than it confirmed them (32.0%), and was inconclusive in a singular case (4.0%).
Conclusions
Cerebral dCTA is an evolving new technology with a diverse spectrum of potential applications. In addition to its role in guiding pre-operative planning for skull base surgical cases, dynamic CTA offers excellent spatial and temporal resolution for assessment of vascular lesions.
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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional committee (Partners Human Research Committee for Partners HealthCare institutions) and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
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The requirement for formal informed consent was waived for this type of retrospective study by our institution.
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Presentation at a Conference: Portions of this manuscript were presented as an oral presentation at the North American Skull Base Society 2017 meeting and as a poster presentation for the Congress of Neurological Surgery 2017 meeting
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Gupta, S., Bi, W.L., Mukundan, S. et al. Clinical applications of dynamic CT angiography for intracranial lesions. Acta Neurochir 160, 675–680 (2018). https://doi.org/10.1007/s00701-018-3465-4
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DOI: https://doi.org/10.1007/s00701-018-3465-4