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
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