title: The role of 4D CT angiography for preoperative screening in patients with intracranial tumors.
abstract: BACKGROUND
  Four-dimensional computed tomography angiography (4D CTA) is now becoming an often used diagnostic imaging modality for the assessment of patients with intracranial tumors. The purpose of this study was to demonstrate the utility of 4D CTA for preoperative screening in patients with intracranial tumors as well as to examine the correlation between perfusion data and grading of gliomas.
  
  
  METHODS
  We performed preoperative screening using 320-row detector CT scanner in 186 patients with intracranial tumors, and 115 patients were finally included in the study. Time-resolved subtracted maximum intensity projection images and volume-rendered images were reconstructed to evaluate vascular structures, tumor staining and incidental lesions. We also evaluated the perfusion functional map for gliomas to find correlations between their vascularity and tumor grading.
  
  
  RESULTS
  We evaluated gliomas in 70 patients, meningiomas in 29, and other tumors in 16. Patients with gliomas of a pathologically higher grade showed high cerebral blood volume (p < 0.05). Tumor staining was observed on MIP images for 12 meningiomas, 4 gliomas, and 3 other tumors. Fifty patients showed a mass effect on vascular structures, seven had cerebral venous sinus obstruction, and two had aneurysms. No iatrogenic accidents with the CT procedure were reported.
  
  
  CONCLUSIONS
  The 4D CTA technique is effective and safe for depicting vascular structures such as arteries, veins, tumor-related vessels, and direct and indirect anatomical complications such as vascular obstruction or vascular compression. This information is useful for preoperative screening. Although 4D CTA also provides perfusion data correlating with the tumor vascularity and grading of gliomas, its clinical value remains limited.
authors.affiliation: Department of Diagnostic Imaging and Nuclear Medicine, Tokyo Women's Medical University, Tokyo, Japan kasuzuki-rad@umin.ac.jp.
authors.forename: Kazufumi
authors.initials: K
authors.lastname: Suzuki
authors.affiliation: Department of Diagnostic Imaging and Nuclear Medicine, Tokyo Women's Medical University, Tokyo, Japan.
authors.forename: Kayoko
authors.initials: K
authors.lastname: Abe
authors.affiliation: Department of Neurological Surgery, Tokyo Women's Medical University, Tokyo, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Maruyama
authors.affiliation: Department of Neurological Surgery, Tokyo Women's Medical University, Tokyo, Japan.
authors.forename: Masayuki
authors.initials: M
authors.lastname: Nitta
authors.affiliation: Department of Neurological Surgery, Tokyo Women's Medical University, Tokyo, Japan.
authors.forename: Kosaku
authors.initials: K
authors.lastname: Amano
authors.affiliation: Department of Neurological Surgery, Tokyo Women's Medical University, Tokyo, Japan.
authors.forename: Koji
authors.initials: K
authors.lastname: Yamaguchi
authors.affiliation: Department of Neurological Surgery, Tokyo Women's Medical University, Tokyo, Japan.
authors.forename: Takakazu
authors.initials: T
authors.lastname: Kawamata
authors.affiliation: Department of Diagnostic Imaging and Nuclear Medicine, Tokyo Women's Medical University, Tokyo, Japan.
authors.forename: Shuji
authors.initials: S
authors.lastname: Sakai
mesh_terms: D000328:Adult; D001932:Brain Neoplasms / Q000000981:diagnostic imaging* / Q000601:surgery; D002533:Cerebral Angiography / Q000379:methods; D000072226:Computed Tomography Angiography / Q000379:methods*; D005260:Female; D056973:Four-Dimensional Computed Tomography / Q000379:methods*; D005910:Glioma / Q000000981:diagnostic imaging* / Q000601:surgery; D006801:Humans; D008297:Male; D008577:Meningeal Neoplasms / Q000000981:diagnostic imaging* / Q000601:surgery; D008579:Meningioma / Q000000981:diagnostic imaging* / Q000601:surgery; D008875:Middle Aged; D057234:Preoperative Period; D012189:Retrospective Studies
keywords: Four-dimensional computed tomography angiography; digital subtraction angiography; glioma; intracranial tumor; perfusion