Stereotactic neurosurgery planning with 3-D spiral CT-angiography.
OBJECTIVE
To assess the feasibility and value of spiral CT angiography of the brain vessels for the planning of neurosurgical stereotactic interventions.


METHODS
Fourty-two patients harboring cerebral lesions underwent spiral CT angiography prior to stereotactic biopsy. Thin spiral CT slices with a collimator slice thickness of 1 mm and a pitch of 1 were used. Multiplanar reconstructions and maximum intensity projections (MIP) were obtained as well as 3-D tissue definition.


RESULTS
There was a sufficient visualization of vessels and of their relationship to the lesion. Tumor neovascularization was clearly demonstrated. Arteries could be shown separately. Stereotactic coordinates of targets were chosen at a safe distance from the vessels and the simulation of tarjectories using the cine loop was made possible. In three cases the presence of a pathological vascularization warned against a stereotactic biopsy.


CONCLUSIONS
Spiral CT angiography seems to yield enough topographical information for the accurate planning of stereotactic surgery for brain lesions. CT angiography with the helical technique is rapid and less invasive than digital subtraction angiography.
Moringlane
J R
JR
Department of Neurosurgery, Saarland University, Homburg/Saar, Germany.
Bartylla
K
K
Hagen
T
T
Waziri
A
A
D000293:Adolescent; D000328:Adult; D000368:Aged; D001932:Brain Neoplasms / Q000000981:diagnostic imaging* / Q000601:surgery*; D002533:Cerebral Angiography / Q000295:instrumentation*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D013238:Stereotaxic Techniques