SEPARATE DEMONSTRATION OF ARTERIAL- AND VENOUS-PHASE BY 3D-CT ANGIOGRAPHY FOR BRAIN TUMORS USING 64-MULTIDETECTOR ROW CT: 3D-CT ARTERIOGRAPHY AND 3D-CT VENOGRAPHY

[Original Article]

HIROMICHI KASUYA¹⁾, MASATO MATSUMOTO¹⁾, RYOJI MUNAKATA¹⁾,
HIROYUKI MURAMATSU¹⁾, TSUYOSHI ICHIKAWA²⁾, TAKU SATO¹⁾,
YUJI ENDO¹⁾, JUN SAKUMA¹⁾, KYOUICHI SUZUKI²⁾,
TATSUYA SASAKI¹⁾ and NAMIO KODAMA¹⁾

¹⁾Department of Neurosurgery, Fukushima Medical University; and, ²⁾Department of Neurosurgery, Fukushima Red Cross Hospital, Fukushima, Japan

(Received November 11, 2008, accepted December 9, 2008)

Abstract: Abstract : We assessed the usefulness of the separate demonstration of the arterial- and venous phase on 3D-CT angiography (3D-CTA) using a 64-multidetector row CT (MDCT) scanner for the surgery of brain tumors.
Nineteen patients with meningiomas (n=11), schwannomas, metastatic brain tumors (n=2 each), glioblastoma multiforme, malignant lymphoma, craniopharyngioma, and embryonal carcinoma (n=1 each) underwent scanning on a 64-MDCT scanner. After dynamic CT scanning to determine the scan timing for the arterial-and venous-phase, we individually scanned the arterial- and venous phase for 4 sec after injecting a nonionic contrast medium. Using the CT threshold setting and subtraction and cutting techniques, we produced individual 3D-CT images of the arteries, veins, tumors, and bones. The operators subjectively assessed the usefulness of these images in comparison with 3D-CTA.
We separately demonstrated the arterial- and venous phase on 3D-CTA covering the entire head in all 19 cases. The 3D-CT arteriographs, 3D-CT venographs, and the fused 3D-CT images facilitated our understanding of the 3D anatomic relationship among the tumor, arteries, veins, and bony structures. In 14 of 19 cases our method provided the surgically valuable findings; the information on the anatomical relation between tumor and the surrounding arteries and veins (in 13 cases) the identification of anatomical course of the encased vessels (in one), and feeding arteries and draining veins (in one), and discrimination between the venous sinus and tumor (in one).

Key words: The anatomical information yielded by our technique makes safer surgery possible. If more detailed information which 3D-CTA cannot provide is required, our method should be performed.

粕谷泰道，松本正人，宗像良二，村松広行，市川剛，佐藤拓，遠藤雄司，佐久間潤，鈴木恭一，佐々木達也，児玉南海雄

Corresponding author: Hiromichi Kasuya
E-mail: kasuya@fmu.ac.jp