Journal
EUROPEAN JOURNAL OF RADIOLOGY
Volume 74, Issue 3, Pages 413-419Publisher
ELSEVIER IRELAND LTD
DOI: 10.1016/j.ejrad.2009.03.015
Keywords
320-MDCT; Whole-brain perfusion; Whole-head subtracted dynamic CTA; Stroke; Carotid stenting
Funding
- Toshiba Medical Systems
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Introduction: Multidetector CT (MDCT) is increasingly used for the investigation of neurovascular disorders, but restricted z-axis coverage (3.2 cm for 64-MDCT) currently limits perfusion to a small portion of the brain close to the circle of Willis, and precludes dynamic angiographic appreciation of the entire brain circulation. We illustrate the clinical potential of recently developed 320-MDCT extending the z-axis coverage to 16 cm in a patient with symptomatic carotid artery stenosis. Methods: In a 74-year-old patient presenting with critical symptomatic stenosis of the left CCA, pre- and post-carotid artery stenting whole-head subtracted dynamic MDCT angiography and perfusion were obtained in addition to CT angiography of the supra-aortic trunks. Both whole-head subtracted MDCT angiography and perfusion demonstrated delayed left ICA circulation, which normalized after carotid stenting. Discussion: 320-MDCT offers unprecedented z-axis coverage allowing for whole-brain perfusion and subtracted dynamic angiography of the entire intracranial circulation. These innovations can consolidate the role of MDCT as a first intention imaging technique for cerebrovascular disorders, in particular for the acute management of stroke. (C) 2009 Elsevier Ireland Ltd. All rights reserved.
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