Intra-arterial CT-angiography for cerebral arteriovenous malformation--initial experiences for treatment planning of radiosurgery.
OBJECTIVE
To clarify the feasibility and effectiveness of intra-arterial CT angiography (IACTA) for treatment planning of arteriovenous malformation radiosurgery.


METHODS
A CT scanner installed in an angiographic examination room was used. Helical IACTA was performed in 22 patients during continuous intra-arterial infusion of contrast medium via the internal carotid or vertebral artery, and dynamic IACTA was performed in 20 of these patients with reconstruction at 0.2-s intervals. The dynamic IACTA was repeated for each 3- or 5-mm increment to encompass the nidus. Subtractions were performed in postembolization cases. A retrospective review of IACTA was performed to assess the effectiveness of dynamic scans.


RESULTS
No complications related to the angiographic procedure or CT imaging were detected. High contrast enhancement was obtained for both helical and dynamic IACTA. In 18 of the 20 cases (90%), draining veins were separated from the nidus by using the enhancement patterns, and in 13 cases (65%), feeding arteries were separated.


CONCLUSIONS
Dynamic IACTA added important information for target-volume determinations. Conventional CT and MRI could be omitted from the protocol, and the period that patients wore the frame was substantially shortened. We conclude that IACTA is a practical and useful method for radiosurgical treatment planning of arteriovenous malformations.
Kunieda
Etsuo
E
Department of Radiology, Keio University, 35 Shinanomachi, Shinjyuku, Tokyo 160-8582, Japan. kunieda@sc.itc.keio.ac.jp
Kawaguchi
Osamu
O
Onozuka
Satoshi
S
Momoshima
Suketaka
S
Takeda
Atsuya
A
Shigematsu
Naoyuki
N
Hashimoto
Subaru
S
Ohira
Takayuki
T
Kubo
Atsushi
A
D000293:Adolescent; D000328:Adult; D002533:Cerebral Angiography; D002648:Child; D005260:Female; D006801:Humans; D002538:Intracranial Arteriovenous Malformations / Q000000981:diagnostic imaging* / Q000601:surgery*; D018810:Magnetic Resonance Angiography; D008297:Male; D008875:Middle Aged; D016634:Radiosurgery; D014057:Tomography, X-Ray Computed