Utility of dynamic computed tomography angiography in the preoperative evaluation of skull base tumors

Bi, Wenya Linda; Brown, Patrick; Abolfotoh, Mohammad; Al‐Mefty, Ossama; Mukundan, Srinivasan; Dunn, Ian F.

doi:10.3171/2014.10.jns141055

Cited by 47 publications

(14 citation statements)

References 9 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…36 Previous studies have shown that preoperative diagnostic angiography and potentially MRI-based angiography can identify lenticulostriate arteries that are encased by the tumor and therefore predict the risk for ischemic complications. 6,25,32 Whether these tools are required for surgical planning should be further studied, especially in high-risk cases such as insular tumors. Interestingly, contrast-enhancing lesions had a significantly lower risk for intraoperative stroke than nonenhancing lesions (Tables 2 and 3).…”

Section: Stroke Incidence and Risk Factorsmentioning

confidence: 99%

Incidence and impact of stroke following surgery for low-grade gliomas

Berger¹,

Tzarfati²,

Costa³

et al. 2021

Journal of Neurosurgery

View full text Add to dashboard Cite

OBJECTIVEIschemic complications are a common cause of neurological deficits following low-grade glioma (LGG) surgeries. In this study, the authors evaluated the incidence, risk factors, and long-term implications of intraoperative ischemic events.METHODSThe authors retrospectively evaluated patients who had undergone resection of an LGG between 2013 and 2017. Analysis included pre- and postoperative demographic, clinical, radiological, and anesthetic data, as well as intraoperative neurophysiology data, overall survival, and functional and neurocognitive outcomes.RESULTSAmong the 82 patients included in the study, postoperative diffusion-weighted imaging showed evidence of acute ischemic strokes in 19 patients (23%), 13 of whom (68%) developed new neurological deficits. Infarcts were more common in recurrent and insular surgeries (p < 0.05). Survival was similar between the patients with and without infarcts. Immediately after surgery, 27% of the patients without infarcts and 58% of those with infarcts experienced motor deficits (p = 0.024), decreasing to 16% (p = 0.082) and 37% (p = 0.024), respectively, at 1 year. Neurocognitive functions before and 3 months after surgery were generally stable for the two groups, with the exception of a decline in verbal rhyming ability among patients with infarcts. Confusion during awake craniotomy was a strong predictor of the occurrence of an ischemic stroke. Mean arterial pressure at the beginning of surgery was significantly lower in the infarct group.CONCLUSIONSRecurrent surgeries and insular tumor locations are risk factors for intraoperative strokes. Although they do not affect survival, these strokes negatively affect patient activity and performance status, mainly during the first 3 postoperative months, with gradual functional improvement over 1 year. Several intraoperative parameters may suggest the impending development of an infarct.

show abstract

Section: Stroke Incidence and Risk Factorsmentioning

confidence: 99%

Incidence and impact of stroke following surgery for low-grade gliomas

Berger¹,

Tzarfati²,

Costa³

et al. 2021

Journal of Neurosurgery

View full text Add to dashboard Cite

show abstract

“…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][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%

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

Tong

Sirhan

Cortes

2021

Indian J Radiol Imaging

View full text Add to dashboard Cite

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.

show abstract

“…Preoperative imaging has traditionally included MR angiography and/or venography (MRA/MRV), CT angiography and/or venography (CTA/CTV), and digital subtraction angiography (DSA) [7]. Each modality has its benefits and limitations.…”

Section: Discussionmentioning

confidence: 99%

Three-dimensional printing technology for treatment of intracranial aneurysm

Yin

et al. 2016

Chin Neurosurg Jl

View full text Add to dashboard Cite

Background: The development of three-dimensional (3D) printing technology provides a new method for surgical treatment, but currently there are few reports on its application in the treatment of aneurysm. The aim of the present study was to explore the materials and methods of fabricating 3D printed individual aneurysm model and its value in the treatment of intracranial aneurysm. Methods: Twenty-four patients with intracranial aneurysm diagnosed by CTA who had undergone operation in our hospital were analyzed retrospectively. CTA Data collected at the time of surgery was used for reconstruction. Soft Mimics 17.0 was used to reconstruct the thin layer CTA scan data into 3D image and the final data was sent to the 3D printer for fabricating the model. We compared the proposed 3D printed model-based preoperative plan and the actual approach used in the surgery based on CTA data to evaluate the value of the 3D printed model in preoperative planning, and picked out the materials which were more suitable for the clinic. Results: Twenty-four aneurysm models with high degree of reality were fabricated successfully with 3D-printing technology. The patients' blood vessels, skulls and aneurysms were printed into the reality model at a ratio of 1:1. It is reported that the soft material-based, 3D printed vascular and aneurysm model more closely resembled the characteristics of the real blood vessels, thus provides a better simulation compared to the plaster-based model. Compared with the original operation plan, 3D printed model could be used for pre-operative aneurysm clip selection, and provide more intuitive information in selection of operational approach. Conclusions: 3D printed model can be used as an operational physical model to design operative schemes, choose the best operative paths and select suitable aneurysm clips by its high simulation degree and individualized characteristics. The model is helpful for surgical planning, especially for the preoperative plan of treating refractory multiple aneurysms and giant aneurysms.

show abstract

Utility of dynamic computed tomography angiography in the preoperative evaluation of skull base tumors

Cited by 47 publications

References 9 publications

Incidence and impact of stroke following surgery for low-grade gliomas

Incidence and impact of stroke following surgery for low-grade gliomas

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

Three-dimensional printing technology for treatment of intracranial aneurysm

Contact Info

Product

Resources

About