Clinical applications of dynamic CT angiography for intracranial lesions

Gupta, Saksham; Bi, Wenya Linda; Mukundan, Srinivasan; Al‐Mefty, Ossama; Dunn, Ian F.

doi:10.1007/s00701-018-3465-4

Cited by 28 publications

(5 citation statements)

References 13 publications

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“…[35][36][37][38] 4D CTA is known to have excellent spatial and temporal resolution and is uniquely helpful in evaluating structures of the skull base. 35,36 In addition, 4D…”

Section: Discussionmentioning

confidence: 99%

“…Although MRI and MRA provide high-quality visualization of the intracranial arteries, the appearance of vascular lesions is influenced by size, flow direction, pulsatility, flow velocity, and degree of thrombosis. 35 38 4D CTA is known to have excellent spatial and temporal resolution and is uniquely helpful in evaluating structures of the skull base. 35 36 In addition, 4D CTA is reported to have a better sensitivity than MRA with better visualization of surrounding vessel anatomy and is less prone to flow-related or motion artifacts.…”

Section: Discussionmentioning

confidence: 99%

“… 35 38 4D CTA is known to have excellent spatial and temporal resolution and is uniquely helpful in evaluating structures of the skull base. 35 36 In addition, 4D CTA is reported to have a better sensitivity than MRA with better visualization of surrounding vessel anatomy and is less prone to flow-related or motion artifacts. 36 Moreover, in our case, 4D CTA was essential in evaluating venous drainage, and in general, is very helpful in planning interventions on complex skull base tumors.…”

Section: Discussionmentioning

confidence: 99%

“…2 7 8 11 13 26 However, important surgical complications include cerebrospinal fluid leak, 7 19 hydrocephalus, 19 and paraparesis. 9 Postoperative endocrine dysfunction can include panhypopituitarism, 5 8 35 diabetes insipidus, 2 6 and syndrome of inappropriate antidiuretic hormone. 6 The option of preoperative embolization is mitigated by risks of infarct.…”

Section: Discussionmentioning

confidence: 99%

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Preoperative Diagnosis of Suprasellar Hemangioblastoma with Four-Dimensional Computed Tomography Angiography: Case Report and Literature Review

Tong

Sirhan

Cortes

2021

Indian J Radiol Imaging

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Purpose Our case report presents the first case of suprasellar hemangioblastoma diagnosed preoperatively with dynamic computed tomography angiography (four-dimensional [4D] CTA) in a patient without Von Hippel-Lindau (VHL) disease. We illustrate the imaging characteristics of these exceedingly rare tumors and discuss the role of 4D CTA in confirming this diagnosis and guiding surgical management. Finally, we present a literature review of imaging findings, differential diagnosis, management, and prognosis. Case A 39-year-old woman known for diabetes mellitus type II and dyslipidemia presented with headache, bitemporal hemianopsia, and mild hyperprolactinemia. Initial diagnosis of suprasellar meningioma separate from pituitary gland was revised to definitive diagnosis of suprasellar hemangioblastoma after 4D CTA. Conclusion Suprasellar hemangioblastomas are extremely rare, often associated to VHL disease. They present as enhancing as suprasellar mass with prominent intra- and peritumoral vascular flow-voids on magnetic resonance imaging. 4D CTA confirms their vascular nature, demonstrates characteristic rapid shunting with feeding arteries, and enlarged draining veins, and is important in guiding surgical management.

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“…[35][36][37][38] 4D CTA is known to have excellent spatial and temporal resolution and is uniquely helpful in evaluating structures of the skull base. 35,36 In addition, 4D…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Preoperative Diagnosis of Suprasellar Hemangioblastoma with Four-Dimensional Computed Tomography Angiography: Case Report and Literature Review

Tong

Sirhan

Cortes

2021

Indian J Radiol Imaging

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“…Thus, the need to include vascular studies such as MR angiography. Our group utilizes a dynamic CT angiography [ 179 , 180 ] as part of the preoperative work-up of pituitary tumors requiring surgical resection. In these relatively rare cases, both lesions might be approached transcranially, as suggested [ 66 ].…”

Section: Factors Related To the Tumor Featuresmentioning

confidence: 99%

The Party Wall: Redefining the Indications of Transcranial Approaches for Giant Pituitary Adenomas in Endoscopic Era

Luzzi

Lucifero

Rabski

et al. 2023

Cancers

Self Cite

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The evolution of endoscopic trans-sphenoidal surgery raises the question of the role of transcranial surgery for pituitary tumors, particularly with the effectiveness of adjunct irradiation. This narrative review aims to redefine the current indications for the transcranial approaches for giant pituitary adenomas in the endoscopic era. A critical appraisal of the personal series of the senior author (O.A.-M.) was performed to characterize the patient factors and the tumor’s pathological anatomy features that endorse a cranial approach. Traditional indications for transcranial approaches include the absent pneumatization of the sphenoid sinus; kissing/ectatic internal carotid arteries; reduced dimensions of the sella; lateral invasion of the cavernous sinus lateral to the carotid artery; dumbbell-shaped tumors caused by severe diaphragm constriction; fibrous/calcified tumor consistency; wide supra-, para-, and retrosellar extension; arterial encasement; brain invasion; coexisting cerebral aneurysms; and separate coexisting pathologies of the sphenoid sinus, especially infections. Residual/recurrent tumors and postoperative pituitary apoplexy after trans-sphenoidal surgery require individualized considerations. Transcranial approaches still have a critical role in giant and complex pituitary adenomas with wide intracranial extension, brain parenchymal involvement, and the encasement of neurovascular structures.

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Neuroimaging Precision Tools and Augmented Reality

Meling

Vargas

2022

Contemporary Skull Base Surgery

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Clinical applications of dynamic CT angiography for intracranial lesions

Abstract: Cerebral dCTA is an evolving new technology with a diverse spectrum of potential applications. In addition to its role in guiding pre-operative planning for skull base surgical cases, dynamic CTA offers excellent spatial and temporal resolution for assessment of vascular lesions.

Cited by 28 publications

References 13 publications

Preoperative Diagnosis of Suprasellar Hemangioblastoma with Four-Dimensional Computed Tomography Angiography: Case Report and Literature Review

Preoperative Diagnosis of Suprasellar Hemangioblastoma with Four-Dimensional Computed Tomography Angiography: Case Report and Literature Review

The Party Wall: Redefining the Indications of Transcranial Approaches for Giant Pituitary Adenomas in Endoscopic Era

Neuroimaging Precision Tools and Augmented Reality

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