CT angiography

The knowledge of patient neuro-anatomy is key information, at least in the understanding of the pathological processes and in the elaboration of precise treatment strategies in neurosurgery. In addition to classical radiology systems like angiography, CT scanner or MRI have greatly contributed to the improvement of the patient anatomy investigation. Each examination modality still carries its own information and the

Owing to ongoing technical refinements and intense scientific and clinical evaluations, computed tomography (CT) of the heart has left the research realm and matured into a clinical application that is about to fulfill its promise to replace invasive cardiac catheterization in selected patient populations. CT coronary angiography is technically more challenging than other CT applications owing to the nature of its target, the continuously moving heart. Rapid technical developments in this field require constant adaptation of acquisition protocols. These challenges, however, are in no way insurmountable for users with knowledge of the general CT technique. The intent of this communication is to provide those interested in and involved with coronary CT angiography with a step-by-step "manual" describing the authors' approach to performing coronary CT angiography. Included are considerations regarding appropriate patient selection, patient medication, radiation protection...

The imaging of brain haemodynamics and its applications are generating growing interest. By providing quantitative measurements of cerebral blood flow (CBF) and cerebral blood volume (CBV), dynamic perfusion computed tomography (p-CT) allows visualisation of cerebral autoregulation mechanisms and represents a fast, available and reliable imaging option for assessing cerebral perfusion. Thanks to its feasibility in emergency settings, p-CT is considered most useful, in combination with CT angiography, in acute ischaemic patients, as it is able to provide a fast and noninvasive assessment of cerebral perfusion impairment. In addition, p-CT can play a diagnostic role in other types of cerebrovascular disease to assess functional reserve, and in intracranial neoplasms, where it has a role in diagnosis, grading, biopsy guidance, and follow-up during treatment. This article illustrates the principles, technique and clinical applications of p-CT cerebral perfusion studies.

Pancreatic pseudoaneurysm rupture is a rare complication of chronic pancreatitis, with severe prognosis and high mortality. Angiography is usually required for confirmation of the diagnosis, but transabdominal ultrasound and CT angiography are useful noninvasive diagnostic methods. We present the case of a 66-year-old patient with a large pancreatic pseudoaneurysm of the superior mesenteric artery complicated with obstructive jaundice. Transabdominal ultrasound with color and power Doppler showed a large pancreatic head pseudoaneurysm that communicated directly to the superior mesenteric artery. Presence of a spinning blood flow inside the pseudoaneurysm was visualized by color Doppler, with evidence of bidirectional flow in the pseudoaneurysm neck that was showed by Doppler spectral analysis. The contrast-enhanced helical computer tomography with multiplanar sagittal and the 3D reconstruction of coronal images confirmed the communication of the pseudoaneurysm with the superior mese...

This study was undertaken to assess the indications and effectiveness of the Amplatzer vascular plug (AVP) system in interventional radiology. Over the past year, we selected 12 patients (seven men and five women; mean age 65.8 years, range 45-82) for the occlusion of five internal iliac arteries (in three aortoiliac aneurysms, one internal iliac aneurysm and one isolated common iliac artery aneurysm), two common iliac arteries (in two ruptured abdominal aortic aneurysms), two subclavian arteries (in aortic arch aneurysms) and three splenic artery aneurysms. We used 15 AVPs (splenic artery aneurysms were excluded, with one AVP in the feeding vessel and one in the draining vessel). We achieved immediate technical success in 12/12 cases. No rupture or dissection of the treated arteries occurred. During the follow-up (mean 4.6 months, range 3-6) computed tomography (CT) angiography and/or contrast-enhanced ultrasound demonstrated complete artery occlusion and aneurysm exclusion. Ease a...

Awareness of the variation and renal vascular abnormality at retroperitoneal space surgeries such as kidney surgery and transplantation is very important and necessary. Complexity in the veins development of the kidney area of fetus leads to a series of changes in the production of these veins, including the extra kidney vein, and the posterior aorta vein. In this case report, we present a case report of a 36-year-old male with a rare renal variation which has been identified with a simple abdominal Computed Tomography (CT) scan (16-slice). In this case report, there is a single renal vein which becomes two branches before drainage into Inferior Vena Cava (IVC) in which one of these branches passes anterior to aorta and the other posterior to aorta which suggests the type of circumaortic left renal vein.

Availability and utilization of computed tomography angiography has been increasing recently. We aimed to assess the effectiveness of low amount of contrast media and low kV value in order to reduce possible side effects of contrast media and to provide optimization of kV value in the evaluation of the carotid artery with multi-detector computed tomography angiography. Forty one patients were randomized into two groups. Contrast media was administered at a dose of 1 ml/kg in group A patients and of 0.5 ml/kg in group B patients. kV value of 120 in group A and 100 in group B were chosen. Bolus tracking technique was used. Attenuation values of certain arterial segments were measured, and values over 200 HU were considered as significant. North American Symptomatic Carotid Endartherectomy Trial criteria were utilized in the evaluation of stenosis. Image quality in arterial segments of all cases was found to be sufficient for diagnosis. Arterial attenuation values were found to be higher in group B than group A. When compared separately in all arterial segments, there was no statistically significant difference between the groups. For stenosis, 615 arterial segments were evaluated. Moderate stenosis in eight segments and severe stenosis in three segments were identified in group A. Occlusion in three segments, severe stenosis in three segments, and moderate stenosis in 25 segments were detected in group B. Better image quality can be obtained, and the amount of contrast media can be reduced using low kV technique in carotid artery multi-detector computed tomography angiography examination.