title: Feasibility of flat panel detector computed tomography for position assessment of external ventricular drainage.
abstract: OBJECTIVE
  New angiographic devices with flat panel detectors allow cross-sectional imaging within the angiographic suite. In patients receiving external ventricular drainage (EVD) to manage hydrocephalus following subarachnoid haemorrhage (SAH), these may help evaluating the position of an EVD without moving the patient to a conventional computed tomography (CT) scanner. It could facilitate patients' management in a life-threatening status. This study therefore compares conventional CT with post-interventional flat panel detector angiographic CT (FDCT) referring to the determinability of an accurate EVD position.
  
  
  METHODS
  Twenty patients with SAH received FDCT and conventional CT for primary assessment after EVD insertion. Three single-blinded raters compared both modalities and evaluated the image sufficiency for determining the EVD position, EVD tip, intracranial course and whether a contorted drainage tube could be detected.
  
  
  RESULTS
  FDCT was sufficient to detect a correct EVD position in 82.5% of the cases vs. 100% in conventional CT. Regarding the EVD tip, FDCT delivered at least 'good' results in 82.5% vs. 95% in conventional CT data. Determining the EVD intracranial course, FDCT provided at least 'good' data in 92.5% vs. 100% in conventional CT. For detecting tube contortion, FDCT provided at least 'good' results in 70% vs. 98% in conventional CT.
  
  
  CONCLUSIONS
  FDCT is a promising method to determine the correct position of an EVD in patients with SAH. Following a neuroradiological intervention, it facilitates the patients' management and renders additional transfers to conventional CT unnecessary in the majority of cases.
authors.affiliation: Department of Neuroradiology, Universitätsmedizin Göttingen, Goettingen, Germany. p.vongottberg@med.uni-goettingen.de
authors.forename: Philipp
authors.initials: P
authors.lastname: von Gottberg
authors.forename: Marios
authors.initials: M
authors.lastname: Psychogios
authors.forename: Gunther
authors.initials: G
authors.lastname: Schuetze
authors.forename: Joseph
authors.initials: J
authors.lastname: Cohnen
authors.forename: Paul
authors.initials: P
authors.lastname: Zwaka
authors.forename: Michael
authors.initials: M
authors.lastname: Knauth
authors.forename: Peter
authors.initials: P
authors.lastname: Schramm
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002404:Catheterization / Q000379:methods; D002533:Cerebral Angiography / Q000379:methods*; D054893:Cone-Beam Computed Tomography / Q000379:methods; D004322:Drainage / Q000379:methods*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D006849:Hydrocephalus / Q000000981:diagnostic imaging* / Q000209:etiology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D013345:Subarachnoid Hemorrhage / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery; D014057:Tomography, X-Ray Computed / Q000379:methods / Q000451:nursing*; D014696:Ventriculostomy / Q000379:methods*