scholarly journals Application of Computed Tomography Angiography Data Monitoring in Cerebral Glioma (Preprint)

2020 ◽  
Author(s):  
Yongmei Yu ◽  
Zhaofeng Du ◽  
Changxin Yuan ◽  
Jian Li ◽  
Bern Ardlee
Keyword(s):  
Computed Tomography ◽  
Computed Tomography Angiography ◽  
Cerebral Blood Volume ◽  
Malignant Tumors ◽  
Mean Transit Time ◽  
Data Monitoring ◽  
Vascular Endothelial ◽  
Cerebral Glioma ◽  
Mirror Area ◽  
Tumor Area

BACKGROUND Background: Glioma are tumors derived from neuroectodermal stromal cells and one of the most common malignant tumors of the brain. OBJECTIVE Objective：The objective is to understand the application of CT angiography in the proliferation of glioma cells more clearly and get more effective diagnosis and treatment of glioma. METHODS Methods： The adult male healthy Sprague Dawley (SD) rats were selected as the research objects to construct the animal models. In addition, respective on the 7th day, 14th day, and the 21st day, the rats were submitted to CT scans. According to parameters and indicators such as cerebral blood flow (CBF), cerebral blood volume (CBV), mean transit time (MTT), and time to peak (TTP), the stained cerebral tissues of rats at different time nodes were further analyzed. RESULTS Results: The results of rat CT manifestation analysis and clinical analysis showed that with the time increased, the volume of the tumors in rats increased apparently, with symptoms such as listlessness appeared at the initial stage and hemiplegia appeared at the later stage. The comparative analysis results of CT parameters at different times nodes showed that in the same tumor area, before the 14th day, CBF, CBV, and TTP showed the increasing trends, which gradually decreased after the 14th day, with significant statistical difference (P<0.01). However, MTT showed a decreasing trend in general, which is not apparent. The results of Vascular endothelial growth factor (VEGF) staining of the tumor area, the peritumoral area, and the contralateral mirror area at different time nodes showed that the vascular endothelial cells, the smooth muscle cells of vessel walls, and the tumor cells were strongly positive. In addition, with the time increased, in the tumor area, the peripheral area, and the contralateral mirror area, the cells increased in both volume and quantity, showing significant differences. CONCLUSIONS Conclusion: Therefore, through the research in this study, it is found that the computed tomography angiography data monitoring can reflect the angiogenesis of rat cerebral glioma. CLINICALTRIAL

scholarly journals Serial Quantitative Computed Tomography Perfusion in Aneurysmal Subarachnoid Hemorrhage

2016 ◽  
Vol 43 (3) ◽  
pp. 375-380 ◽  
Author(s):  
Cheemun Lum ◽  
Matthew J. Hogan ◽  
John Sinclair ◽  
Shane English ◽  
Howard Lesiuk ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Subarachnoid Hemorrhage ◽  
Middle Cerebral Artery ◽  
Transit Time ◽  
Cerebral Artery ◽  
Computed Tomography Angiography ◽  
Aneurysmal Subarachnoid Hemorrhage ◽  
Mean Transit Time ◽  
Arterial Diameter ◽  
Computed Tomography Perfusion

AbstractPurpose: Computed tomography perfusion (CTP) has been performed to predict which patients with aneurysmal subarachnoid hemorrhage are at risk of developing delayed cerebral ischemia (DCI). Patients with severe arterial narrowing may have significant reduction in perfusion. However, many patients have less severe arterial narrowing. There is a paucity of literature evaluating perfusion changes which occur with mild to moderate narrowing. The purpose of our study was to investigate serial whole-brain CTP/computed tomography angiography in aneurysm-related subarachnoid hemorrhage (aSAH) patients with mild to moderate angiographic narrowing. Methods: We retrospectively studied 18 aSAH patients who had baseline and follow-up whole-brain CTP/computed tomography angiography. Thirty-one regions of interest/hemisphere at six levels were grouped by vascular territory. Arterial diameters were measured at the circle of Willis. The correlation between arterial diameter and change in CTP values, change in CTP in with and without DCI, and response to intra-arterial vasodilator therapy in DCI patients was evaluated. Results: There was correlation among the overall average cerebral blood flow (CBF; R=0.49, p<0.04), mean transit time (R=–0.48, p=0.04), and angiographic narrowing. In individual arterial territories, there was correlation between changes in CBF and arterial diameter in the middle cerebral artery (R=0.53, p=0.03), posterior cerebral artery (R=0.5, p=0.03), and anterior cerebral artery (R=0.54, p=0.02) territories. Prolonged mean transit time was correlated with arterial diameter narrowing in the middle cerebral artery territory (R=0.52, p=0.03). Patients with DCI tended to have serial worsening of CBF compared with those without DCI (p=0.055). Conclusions: Our preliminary study demonstrates there is a correlation between mild to moderate angiographic narrowing and serial changes in perfusion in patients with aSAH. Patients developing DCI tended to have progressively worsening CBF compared with those not developing DCI.

scholarly journals Systematic evaluation of computed tomography angiography collateral scores for estimation of long-term outcome after mechanical thrombectomy in acute ischaemic stroke

2019 ◽  
Vol 32 (4) ◽  
pp. 277-286 ◽  
Author(s):  
Daniel Weiss ◽  
Bastian Kraus ◽  
Christian Rubbert ◽  
Marius Kaschner ◽  
Sebastian Jander ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Computed Tomography Angiography ◽  
Cerebral Blood Volume ◽  
Mechanical Thrombectomy ◽  
Favourable Outcome ◽  
Index Score ◽  
Modified Rankin Scale ◽  
Rater Reliability ◽  
Endovascular Thrombectomy ◽  
Computed Tomography Perfusion

Purpose This study compares computed tomography angiography-based collateral scoring systems in regard to their inter-rater reliability and potential to predict functional outcome after endovascular thrombectomy, and relates them to parenchymal perfusion as measured by computed tomography perfusion. Methods Eighty-four patients undergoing endovascular thrombectomy in anterior circulation ischaemic stroke were enrolled. Modified Tan Score, Miteff Score, Maas Score and Opercular Index Score ratio were assessed in pre-interventional computed tomography angiographies independently by two readers. Collateral scores were tested for inter-rater reliability by weighted-kappa, for correlations with three-months modified Rankin Scale, and their potential to differentiate between patients with favourable (modified Rankin Scale ≤2) and poor outcome (modified Rankin Scale ≥3). Correlations with relative cerebral blood volume and relative cerebral blood flow were tested in patients with available computed tomography perfusion. Results Very good inter-rater reliability was found for Modified Tan, Miteff and Opercular Index Score ratio, and substantial reliability for Maas. There were no significant correlations between collateral scores and three-months modified Rankin Scale, but significant group differences between patients with favourable and poor outcome for Maas, Miteff and Opercular Index Score ratio. Miteff and Maas were significant predictors of favourable outcome in binary logistic regression analysis. Miteff best differentiated between both outcome groups in receiver-operating characteristics, and Maas reached highest sensitivity for favourable outcome prediction of 96%. All collateral scores significantly correlated with mean relative cerebral blood volume and relative cerebral blood flow. Conclusions Computed tomography angiography scores are valuable in estimating functional outcome after mechanical thrombectomy and reliable across readers. The more complex scores, Maas and Miteff, show the best performances in predicting favourable outcome.

scholarly journals Utility of computed tomography perfusion in detection of cerebral vasospasm in patients with subarachnoid hemorrhage

2006 ◽  
Vol 21 (3) ◽  
pp. 1-5 ◽  
Author(s):  
Roham Moftakhar ◽  
Howard A. Rowley ◽  
Aquilla Turk ◽  
David B. Niemann ◽  
Beverly Aagaard Kienitz ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Subarachnoid Hemorrhage ◽  
Cerebral Vasospasm ◽  
Cerebral Blood Volume ◽  
Ct Perfusion ◽  
Mean Transit Time ◽  
Digital Subtraction ◽  
Noninvasive Method ◽  
Computed Tomography Perfusion ◽  
Intent To Treat

Object Digital subtraction (DS) angiography is the gold standard for detecting cerebral vasospasm after subarachnoid hemorrhage (SAH). Computed tomography (CT) perfusion is a recently developed modality for the evaluation of cerebral hemodynamics. This study was conducted to evaluate the potential of using CT perfusion to detect vasospasm in patients with SAH. Methods Fourteen patients between the ages of 41 and 66 years with aneurysmal SAH underwent 23 CT perfusion scans for suspected vasospasm. All patients underwent DS angiography within 12 hours of the CT perfusion scans. The presence of vasospasm on CT perfusion images was determined based on qualitative reading using color maps of mean transit time, cerebral blood flow, and cerebral blood volume as criteria. The presence or absence of vasospasm as retrospectively determined using CT perfusion was compared with DS angiography findings. Of the 23 CT perfusion scans performed, 21 (91%) were concordant with angiography findings in predicting the presence or absence of vasospasm. In 15 of 23 scans, the presence of vasospasm was detected on CT perfusion scans and confirmed on DS angiography studies. In two cases, vasospasm was revealed on DS angiography but was not confirmed on CT perfusion. The degree of agreement between CT perfusion and DS angiography for detection of vasospasm was high (κ = 0.8, p < 0.0001). Conclusions Computed tomography perfusion is an accurate, reliable, and noninvasive method to detect the presence or absence of vasospasm. It can be used as a tool to help guide the decision to pursue DS angiography with the intent to treat vasospasm.

scholarly journals Implementation of Computed Tomography Angiography (CTA) and Computed Tomography Perfusion (CTP) in Polish Guidelines for Determination of Cerebral Circulatory Arrest (CCA) during Brain Death/Death by Neurological Criteria (BD/DNC) Diagnosis Procedure

2021 ◽  
Vol 10 (18) ◽  
pp. 4237
Author(s):  
Romuald Bohatyrewicz ◽  
Joanna Pastuszka ◽  
Wojciech Walas ◽  
Katarzyna Chamier-Cieminska ◽  
Wojciech Poncyljusz ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Brain Death ◽  
Computed Tomography Angiography ◽  
Cerebral Blood Volume ◽  
New Technologies ◽  
Circulatory Arrest ◽  
Brain Regions ◽  
National Guidelines ◽  
Computed Tomography Perfusion ◽  
Cerebral Circulatory Arrest

Background: Brain death/death by neurologic criteria (BD/DNC) guidelines are routinely analyzed, compared and updated in the majority of countries and are later implemented as national criteria. At the same time, extensive works have been conducted in order to unify clinical procedures and to validate and implement new technologies into a panel of ancillary tests. Recently evaluated computed tomography angiography and computed tomography perfusion (CTA/CTP) seem to be superior to traditionally used digital subtraction angiography (DSA), transcranial Doppler (TCD) and cerebral perfusion scintigraphy for diagnosis of cerebral circulatory arrest (CCA). In this narrative review, we would like to demonstrate scientific evidence supporting the implementation of CTA/CTP in Polish guidelines for BD/DNC diagnosis. Research and implementation process: In the first of our base studies concerning the potential usefulness of CTA/CTP for the confirmation of CCA during BD/DNC diagnosis procedures, we showed a sensitivity of 96.3% of CTA in a group of 82 patients. CTA was validated against DSA in this report. In the second study, CTA showed a sensitivity of 86% and CTP showed a sensitivity of 100% in a group of 50 patients. In this study, CTA and CTP were validated against clinical diagnosis of BD/DNC supported by TCD. Additionally, we propose our CCA criteria for CTP test, which are based on ascertainment of cerebral blood flow (CBF) < 10 mL/100 g/min and cerebral blood volume < 1 mL/100 g in regions of interest (ROIs) localized in all brain regions. Based on our research results, CTA/CTP methods were implemented in Polish BD/DNC criteria. To our knowledge, CTP was implemented for the first time in national guidelines. Conclusions: CTA and CTP-derived CTA might be in future the tests of choice for CCA diagnosis, proper and/or Doppler pretest might significantly increase sensitivity of CTA in CCA diagnosis procedures. Whole brain CTP might be decisive in some cases of inconclusive CTA. Implementation of CTA/CTP in the Polish BD/DNC diagnosis guidelines does not show any major obstacles. We believe that in next edition of “The World Brain Death Project” CTA and CTP will be recommended as ancillary tests of choice for CCA confirmation during BD/DNC diagnosis procedures.

scholarly journals Observer Agreement on Computed Tomography Perfusion Imaging in Acute Ischemic Stroke

Stroke ◽  
2019 ◽  
Vol 50 (11) ◽  
pp. 3108-3114 ◽  
Author(s):  
Salwa El-Tawil ◽  
Grant Mair ◽  
Xuya Huang ◽  
Eleni Sakka ◽  
Jeb Palmer ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Time Delay ◽  
Acute Stroke ◽  
Transit Time ◽  
Delay Time ◽  
Cerebral Blood Volume ◽  
Mean Transit Time ◽  
Observer Agreement ◽  
Intraobserver Agreement ◽  
Noncontrast Ct

Background and Purpose— Computed tomography (CT) perfusion (CTP) provides potentially valuable information to guide treatment decisions in acute stroke. Assessment of interobserver reliability of CTP has, however, been limited to small, mostly single center studies. We performed a large, internet-based study to assess observer reliability of CTP interpretation in acute stroke. Methods— We selected 24 cases from the IST-3 (Third International Stroke Trial), ATTEST (Alteplase Versus Tenecteplase for Thrombolysis After Ischaemic Stroke), and POSH (Post Stroke Hyperglycaemia) studies to illustrate various perfusion abnormalities. For each case, observers were presented with noncontrast CT, maps of cerebral blood volume, cerebral blood flow, mean transit time, delay time, and thresholded penumbra maps (dichotomized into penumbra and core), together with a short clinical vignette. Observers used a structured questionnaire to record presence of perfusion deficit, its extent compared with ischemic changes on noncontrast CT, and an Alberta Stroke Program Early CT Score for noncontrast CT and CTP. All images were viewed, and responses were collected online. We assessed observer agreement with Krippendorff-α. Intraobserver agreement was assessed by inviting observers who reviewed all scans for a repeat review of 6 scans. Results— Fifty seven observers contributed to the study, with 27 observers reviewing all 24 scans and 17 observers contributing repeat readings. Interobserver agreement was good to excellent for all CTP. Agreement was higher for perfusion maps compared with noncontrast CT and was higher for mean transit time, delay time, and penumbra map (Krippendorff-α =0.77, 0.79, and 0.81, respectively) compared with cerebral blood volume and cerebral blood flow (Krippendorff-α =0.69 and 0.62, respectively). Intraobserver agreement was fair to substantial in the majority of readers (Krippendorff-α ranged from 0.29 to 0.80). Conclusions— There are high levels of interobserver and intraobserver agreement for the interpretation of CTP in acute stroke, particularly of mean transit time, delay time, and penumbra maps.

scholarly journals Computed tomography perfusion imaging after aneurysmal subarachnoid hemorrhage can detect cerebral vasospasm and predict delayed cerebral ischemia after endovascular treatment

2020 ◽  
Vol 11 ◽  
pp. 233
Author(s):  
Koji Omoto ◽  
Ichiro Nakagawa ◽  
Fumihiko Nishimura ◽  
Shuichi Yamada ◽  
Yasushi Motoyama ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Subarachnoid Hemorrhage ◽  
Endovascular Treatment ◽  
Clinical Outcomes ◽  
Cerebral Vasospasm ◽  
Cerebral Blood Volume ◽  
Aneurysmal Subarachnoid Hemorrhage ◽  
Mean Transit Time ◽  
Delayed Cerebral Ischemia ◽  
Computed Tomography Perfusion

Background: Endovascular treatment (ET) can improve angiographic cerebral vasospasm (CV) after aneurysmal subarachnoid hemorrhage, but was unrelated to clinical outcomes in previous analyses. Appropriate detection of CV and precise indications for ET are required. This study investigated whether changes in computed tomography perfusion (CTP) parameter can determine indications for ET in CV and predict its effectiveness. Methods: Participants comprised 140 patients who underwent neck clipping or coil embolization. CTP was performed a week after aneurysmal treatment or when clinical deterioration had occurred. Patients were divided into ET and non-ET groups by propensity score matching. In addition, the ET group was divided into subgroups with and without new cerebral infarction (CI). All CTP images in the three groups were retrospectively investigated qualitatively and quantitatively. CI was diagnosed from CT at 3 months postoperatively. Results: Of the 121 patients examined, 15 patients (11%) needed ET. In qualitative analysis, all ET group patients displayed extension of time-to-peak (TTP) at the region of vasospastic change, regardless of the presence of CI. Quantitative analysis showed significant decreases in cerebral blood volume (P < 0.01), cerebral blood flow (CBF) (P < 0.001), and extension in TTP (P < 0.01) in the ET group compared with the non-ET group. A significant decrease in CBF (P < 0.001) and extension in mean transit time (P < 0.001) was seen in the ET with CI subgroup compared with the ET without CI subgroup. Conclusion: CTP in the vasospastic period may be an indication for ET and predict the effectiveness of ET for CV to improve clinical outcomes.

scholarly journals Preoperative computed tomography angiography (CTA) of the body in vascular patients: prevalence and significance of unsuspected extravascular findings

2019 ◽  
Vol 191 (08) ◽  
pp. 716-724
Author(s):  
Larissa Sarah Turowski ◽  
Marco Dollinger ◽  
Walter A. Wohlgemuth ◽  
Moritz Wildgruber ◽  
Lukas Philipp Beyer ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Surgical Treatment ◽  
Computed Tomography Angiography ◽  
Malignant Tumors ◽  
Vascular Diseases ◽  
The Body ◽  
Radiology Reports ◽  
Institutional Review ◽  
Clinically Significant

Purpose Evaluation of the prevalence and significance of unsuspected extravascular findings on computed tomography angiography (CTA) of the body before endovascular or surgical treatment in vascular patients. Materials and Methods This study was approved by the local institutional review board. Radiology reports of 806 patients who underwent CTA of the body during January 2004 until December 2014 before endovascular or surgical treatment of vascular diseases were retrospectively reviewed. All unexpected extravascular abnormalities were classified as clinically non-significant (requiring no follow-up) or clinically significant (requiring further follow-up/immediate treatment). The course of patients with significant extravascular findings was retrospectively evaluated. Results Overall 806 patients were included in this study (592 men; mean age: 67 years). In 778 (96.5 %) of 806 patients 3293 incidental extravascular findings were diagnosed. There were 259 suspicious findings in 205 patients (25.4 %) that required further follow-up or immediate treatment. A previously unknown malignant tumor was diagnosed in 23 (2.9 %) patients. 10 patients (1.2 %) were diagnosed with lung cancer. Malignant tumors were detected more often in men than in women (3.5 % versus 0.9 %). Patients with an incidental tumor were significantly older than patients without a tumor (mean age: 72.3 vs. 67.5 years). Conclusion Clinically significant unexpected extravascular findings are common in vascular patients. Especially noteworthy are malignant tumors of the lung. Key points  Citation Format

scholarly journals Perfusion Computed Tomography Scan Imaging in Differentiation of Benign from Malignant Parotid Lesions

2019 ◽  
Vol 24 (02) ◽  
pp. e160-e169
Author(s):  
Masume Niazi ◽  
Maryam Mohammadzadeh ◽  
Kayvan Aghazadeh ◽  
Hashem Sharifian ◽  
Ebrahim Karimi ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Parotid Gland ◽  
Malignant Tumors ◽  
Ct Perfusion ◽  
Mean Transit Time ◽  
Perfusion Ct ◽  
Perfusion Computed Tomography ◽  
Parotid Tumors ◽  
The Mean ◽  
Malignant Parotid Tumors

Abstract Introduction The most common site of salivary gland tumors is the parotid gland. Computed tomography (CT), magnetic resonance imaging (MRI), and sonography are imaging modalities to differentiate benign from malignant parotid tumors. Objective The aim of this study is the evaluation of the diagnostic value of perfusion CT for differentiating histological categorization of benign and malignant parotid tumors. Methods A total of 29 patients with parotid neoplasms were enrolled in this study. Mean age and all CT perfusion variables (gradient and permeability, blood flow [BF], blood volume [BV], mean transit time [MTT], permeability surface [PS], maximum intensity projection [MIP], time-density curve [TDC], and time to peak [TTP]) were compared among three groups (malignant tumors [MTs], Warthin's tumor [WT] and pleomorphic adenomas [PA]). Results The mean age of the patients was 55.9 ± 14.1 (26–77), and 15 of them were male (51.7%). Eleven lesions were PAs [37.9%], 8 lesions were WTs (27.6%0 and 10 lesions (34.5%) were MTs (6 acinic cell carcinomas [ACCs], 3 adenocystic carcinomas [AdCCs], and 1 mucoepidermoid carcinoma [MEC]). The mean age of the patients with WTs was 62 ± 7.5 years; 52 ± 14.2 for patients with Pas, and 55.2 ± 17.2 for those with MTs (p = 0.32). The mean MIP was 122.7 ± 12.2 in WT, while it was 80.5 ± 19.5 in PA, and 76.2 ± 27.1 in MTs (p < 0.001); The mean MIP for WT was higher than for PAs and MTs; the values of MTs and PAs were not statistically different. The average of BF, BV, and curve peak were higher in WTs in comparison with the other two groups, and curve time 2 and TTP were higher in PAs in comparison with MTs. Conclusion Based on this study, perfusion CT of the parotid gland and its parameters can distinguish between benign and malignant parotid masses.

Mid-aortic syndrome: computed tomography angiography depicting extensive collateral circulation in an 11-year-old patient with thoracoabdominal aortic coarctation

VASA ◽  
2012 ◽  
Vol 41 (2) ◽  
pp. 132-135 ◽  
Author(s):  
Krohn ◽  
Gebauer ◽  
Hübler ◽  
Beck
Keyword(s):  
Computed Tomography ◽  
Computed Tomography Angiography ◽  
Collateral Circulation ◽  
Intestinal Ischemia ◽  
Clinical Presentation ◽  
Lower Limbs ◽  
Upper Body ◽  
Descending Aorta ◽  
Before And After ◽  
Blood Pressures

The mid-aortic syndrome is an uncommon clinical condition characterized by severe narrowing of the descending aorta, usually with involvement of its renal and visceral branches, presenting with uncontrollably elevated blood pressures of the upper body, renal and cardiac failure, intestinal ischemia, encephalopathy symptoms and claudication of the lower limbs, although clinical presentation is variable. In this article we report the case of an eleven-year-old patient with the initial diagnosis of a mid-aortic syndrome and present the computed tomography angiography pictures and reconstructions before and after surgical therapy.

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