Intracranial and Cervical Three-Dimensional Computed Tomography Angiography Using a Multislice Computed Tomography System: Initial Clinical Experience

Abstract

After the introduction of a new multislice computed tomography (MSCT) scanner, it has become possible to produce high-speed CT angiography (CTA) of high quality for the intracranial and cervical vessels. In our initial experience, 66 consecutive patients with known or suspected carotid and/or intracranial arterial lesions underwent CTA using a MSCT scanner. Three scanning techniques were adopted for 1. high-speed CTA covering both cervical and intracranial vessels; 2. high-quality intracranial imaging and high-speed cervical imaging with double injection of contrast materials; and 3. high-quality CTA for intracranial vessels. A total of 90-105 ml of contrast material (300 mgI, non-ionic) was injected at a rate of 3 ml/s using a power injector. With a MSCT scanner, three-dimensional (3D) CTA images of excellent quality were obtained in all cases without overlapping of cavernous sinuses and intracranial veins because of shorter acquisition time. Approximately 25 cm of scanning extent, enough to cover from the carotid bifurcation to distal cerebral arteries, could be obtained in 16 s with good image quality. In the visualization of small branches, high-speed CTA of high quality was equivalent to intra-arterial digital subtraction angiography (IADSA) and superior to magnetic resonance angiography. The MSCT scanner can provide 3D CTA of excellent quality with significantly shorter acquisition time in the intracranial and cervical regions.