Initial experience with a combined multidetector CT and biplane digital subtraction angiography suite with a single interactive table for the diagnosis and treatment of neurovascular disease
- Joseph J Gemmete1,
- Neeraj Chaudhary1,
- Aditya S Pandey2,
- Yaseen Oweis3,
- B Greg Thompson2,
- Cormac O Maher2,
- Dheeraj Gandhi4,
- Sameer A Ansari5,6
- 1Department of Radiology, Division of Neurointerventonal Radiology, University of Michigan Health System, Ann Arbor, Michigan, USA
- 2Department of Neurosurgery, University of Michigan Health System, Ann Arbor, Michigan, USA
- 3University of Michigan Medical School, Ann Arbor, Michigan, USA
- 4Department of Radiology, Division of Neurointerventional Radiology, Johns Hopkins University Hospitals, Baltimore, Maryland, USA
- 5Department of Radiology, Division of Neurointerventional Radiology, Northwestern University Hospitals, Chicago, Illinois, USA
- 6Department of Neurosurgery, Northwestern University Hospitals, Chicago, Illinois, USA
- Correspondence to Dr Joseph J Gemmete, Department of Radiology, Division of Interventional Neuroradiology, University of Michigan Health System, 1500 East Medical Center Drive, UH B1 D328, Ann Arbor, MI 48109-0030, USA;
Contributors The submitted work has not been published or submitted elsewhere for review; all of the authors have been personally and actively involved in the work leading to this manuscript and will thus hold themselves, jointly and individually, responsible for its content.
- Received 9 June 2011
- Revised 5 August 2011
- Accepted 2 September 2011
- Published Online First 27 September 2011
Background A combined imaging suite is useful in the diagnosis and treatment of vascular disease involving the head and neck. This study demonstrates the utility of a multidetector row CT and biplane digital subtraction angiography (DSA) system (hybrid suite) with a single interactive table for the evaluation and treatment of neurovascular disease.
Methods 30 patients were studied utilizing the hybrid suite. Direct intra-arterial and selective intravenous injection of contrast with CT imaging (IA-CTA and IV-CTV) was performed in nine vascular tumors, three intracranial arteriovenous malformations, four spinal vascular lesions, one aneurysm and two inferior petrosal sinus sampling cases. Angiography with CT perfusion (CTP) imaging was obtained in five temporary balloon occlusion tests, two ischemic stroke and two vasospasm cases. A CT scan of the head was obtained in two cases during aneurysm coiling. The value of the IA-CTA and IV-CTV images compared with conventional CT and MRI images was qualitatively assessed.
Results All studies were technically successful with no complications. IA-CTA and IV-CTV were useful in the diagnosis and treatment of vascular disease. All IA-CTA and IV-CTV images were qualitatively graded as superior to conventional imaging. CTP imaging provided information about the penumbra and area of infarction in five temporary balloon test occlusions, two ischemic stroke and two vasospasm cases. A CT scan of the head provided timely information in two aneurysm coiling cases. The hybrid suite allowed angiography and CT scanning to be performed immediately without patient transfer.
Conclusion This hybrid suite improves the diagnostic and therapeutic capabilities of treating a multitude of neurovascular diseases.
- arteriovenous malformation
- CT angiography
- vascular malformation
- posterior fossa
- spinal cord
Competing interests None.
Ethics approval This study was approved by Institutional Review Board (IRB).
Provenance and peer review Not commissioned; externally peer reviewed.