4D Flat Panel Conebeam CTA for Analysis of the Angioarchitecture of Cerebral AVMs with a Novel Software Prototype.


Journal

AJNR. American journal of neuroradiology
ISSN: 1936-959X
Titre abrégé: AJNR Am J Neuroradiol
Pays: United States
ID NLM: 8003708

Informations de publication

Date de publication:
01 2022
Historique:
received: 11 06 2021
accepted: 22 09 2021
entrez: 14 1 2022
pubmed: 15 1 2022
medline: 11 3 2022
Statut: ppublish

Résumé

Time-resolved 3DRA (4D-DSA) and flat panel conebeam CTA are new methods for visualizing the microangioarchitecture of cerebral AVMs. We applied a 4D software prototype to a series of cases of AVMs to assess the utility of this method in relation to treatment planning. In 33 patients with AVMs, 4D volumes and flat panel conebeam CTA images were recalculated from existing 3D rotational angiography data. The multiplanar reconstructions were used to determine intranidal arteriovenous branching patterns, categorize them according to common classifications of AVM angioarchitecture, and compare the results with those from 2D-DSA. 4D flat panel conebeam CTA showed angioarchitectural features equal to or better than those of 2D-DSA in 30 of 33 cases. In particular, the reconstructions helped in understanding the intranidal microvasculature. Fistulous direct arteriovenous connections with a low degree of arterial branching ( 4D flat panel conebeam CTA reconstructions allow detailed analysis of the nidal angioarchitecture of AVMs. However, further improvements in temporal resolution and automated reconstruction techniques are needed to use the method generally in clinical practice.

Sections du résumé

BACKGROUND AND PURPOSE
Time-resolved 3DRA (4D-DSA) and flat panel conebeam CTA are new methods for visualizing the microangioarchitecture of cerebral AVMs. We applied a 4D software prototype to a series of cases of AVMs to assess the utility of this method in relation to treatment planning.
MATERIALS AND METHODS
In 33 patients with AVMs, 4D volumes and flat panel conebeam CTA images were recalculated from existing 3D rotational angiography data. The multiplanar reconstructions were used to determine intranidal arteriovenous branching patterns, categorize them according to common classifications of AVM angioarchitecture, and compare the results with those from 2D-DSA.
RESULTS
4D flat panel conebeam CTA showed angioarchitectural features equal to or better than those of 2D-DSA in 30 of 33 cases. In particular, the reconstructions helped in understanding the intranidal microvasculature. Fistulous direct arteriovenous connections with a low degree of arterial branching (
CONCLUSIONS
4D flat panel conebeam CTA reconstructions allow detailed analysis of the nidal angioarchitecture of AVMs. However, further improvements in temporal resolution and automated reconstruction techniques are needed to use the method generally in clinical practice.

Identifiants

pubmed: 35027345
pii: 43/1/102
doi: 10.3174/ajnr.A7382
pmc: PMC8757557
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

102-109

Informations de copyright

© 2022 by American Journal of Neuroradiology.

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Auteurs

F Keil (F)

From the Institute of Neuroradiology (F.K., A. Bergkemper., J.B.), University of Frankfurt, Frankfurt, Germany Fee.Keil@kgu.de.

A Bergkemper (A)

From the Institute of Neuroradiology (F.K., A. Bergkemper., J.B.), University of Frankfurt, Frankfurt, Germany.

A Birkhold (A)

Siemens Healthcare (A. Birkhold, M.K.), Forchheim, Germany.
Advanced Therapies (A. Birkhold, M.K.), Siemens Healthcare, Forchheim, Germany.

M Kowarschik (M)

Siemens Healthcare (A. Birkhold, M.K.), Forchheim, Germany.
Advanced Therapies (A. Birkhold, M.K.), Siemens Healthcare, Forchheim, Germany.

S Tritt (S)

Helios Dr. Horst Schmidt Kliniken Wiesbaden (S.T.), Wiesbaden, Germany.

J Berkefeld (J)

From the Institute of Neuroradiology (F.K., A. Bergkemper., J.B.), University of Frankfurt, Frankfurt, Germany.

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Classifications MeSH