4D Flat Panel Conebeam CTA for In Vivo Imaging of the Microvasculature of the Human Cortex with a Novel Software Prototype.

J Berkefeld,A Birkhold,F Keil,N Huizinga,M Kowarschik,S Tritt

doi:10.3174/ajnr.a6574

Abstract

It was the aim of our pilot study to investigate whether time-resolved flat panel conebeam CTA is able to demonstrate small cortical vessels in vivo. In 8 patients with small AVMs, time-resolved coronal MPRs of the vasculature of the frontal cortex were recalculated from 3D rotational angiography datasets with the use of a novel software prototype. 4D flat panel conebeam CTA demonstrated the course of the cortical arteries with small perpendicular side branches to the underlying cortex. Pial arterial and venous networks could also be identified, corresponding to findings in injection specimens. Reasonable image quality was achieved in 6 of 8 cases. In this small study, in vivo display of the cortical microvasculature with 4D flat panel conebeam CTA was feasible and superior to other angiographic imaging modalities.

Highlights

MATERIALS AND METHODSTime-resolved coronal MPRs of the vasculature of the frontal cortex were recalculated from routinely acquired 3D rotational angiography (3DRA) datasets
For 3D rotational angiography (3DRA), the rotation angle was 260° with 2 runs of 12 seconds each
We evaluated the cortical microvasculature, according to 4D-flat panel conebeam CTA (FPCBCTA) MPRs in a coronal plane perpendicular to the course of the frontal gyri and sulci

Summary

MATERIALS AND METHODS

Time-resolved coronal MPRs of the vasculature of the frontal cortex were recalculated from routinely acquired 3DRA datasets. The patients had justifying indications for a 3DRA protocol with a prolonged scan time of 12 seconds for treatment planning of AVMs. For evaluation of the normal microvasculature, we selected 8 consecutive patients with small supratentorial AVMs with a nidus size of ,3 cm and without major compromise of hemodynamics in the frontal cortex. For the reconstruction of 4D volumes and corresponding MPRs, the projection images were transferred to a dedicated workstation (syngo X Workplace VD20; Siemens) equipped with a software prototype as an extension of the currently available syngo Dyna4D software (Siemens). The MPR with the best filling of small vessels was selected according to a cine display of the sequence of time-resolved MPRs, which is available at any time point during the scan time of 12 seconds. Identification of vascular structures and image documentation was by consensus of 2 reviewers

RESULTS

DISCUSSION

CONCLUSIONS