Advanced cone-beam CT venous angiographic imaging

Area of Science:

• Neuroradiology
• Vascular Imaging

Background:

• Dural venous sinus evaluation commonly uses MR or CT venography.
• Diagnostic cerebral angiography is used for further assessment.
• Three-dimensional rotational angiography (3D-RA) can be adapted for venous imaging as 3D rotational venography (3D-RV).

Observation:

• A retrospective review of 12 patients who underwent 3D-RV at Baylor St. Luke's Medical Center was conducted.
• The technique involves standard 3D-RA protocols with catheter placement in the internal carotid artery and adjusted x-ray delay.
• Conditions evaluated included venous sinus neoplasms, idiopathic intracranial hypertension with venous sinus stenosis, venous diverticula, and arachnoid cysts.

Findings:

• 3D-RV provided diagnostic insights and aided treatment planning for various cerebrovascular conditions.
• The x-ray delay ranged from 7 to 10 seconds.
• Cross-sectional reconstructions offered additional anatomical detail.

Implications:

• 3D-RV serves as a valuable adjunct to traditional angiography for assessing cerebral venous vasculature.
• The technique is relatively easy to perform on standard biplane equipment.
• Potential applications include evaluating venous sinus stenosis, diverticula, and tumors invading venous sinuses.