NDLI: Perfusion CT scanning and CT angiography in the evaluation of extracranial-intracranial bypass grafts.

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Perfusion CT scanning and CT angiography in the evaluation of extracranial-intracranial bypass grafts.

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Langner, Soenke Fleck, Steffen Seipel, Rebecca Schroeder, Henry W. S. Hosten, Norbert Kirsch, Michael
Description	Country affiliation: Germany Author Affiliation: Langner S ( Institute for Diagnostic Radiology and Neuroradiology, Ernst-Moritz-Arndt-University Greifswald, Germany. soenke.langner@uni-greifswald.de)
Abstract	OBJECT: Extracranial-intracranial (EC-IC) bypass surgery remains an important treatment alternative for patients with occlusive cerebrovascular disease. The aim of the present study was to use perfusion CT and CT angiography (CTA) to evaluate cerebral hemodynamics and bypass patency in patients with occlusive cerebrovascular disease before and after EC-IC bypass surgery. METHODS: Ten patients underwent perfusion CT and CTA before and after bypass surgery. Preoperative and postoperative digital subtraction angiography served as the diagnostic gold standard. An artery bypass was established from the superficial temporal artery to a cortical branch of the middle cerebral artery. Perfusion CT scanning was performed at the level of the basal ganglia. Color-coded perfusion maps of cerebral blood volume, cerebral blood flow, and time to peak were calculated. RESULTS: Preoperative perfusion CT showed significant prolonged time to peak and reduced cerebral blood flow of the affected hemisphere. Postoperative neurological deterioration did not develop in any patient. Computed tomography angiography provided adequate evaluation of the anastomoses as well as the course and caliber of the bypass and confirmed bypass patency in all patients. Postoperative perfusion CT showed improved cerebral hemodynamics with a return to nearly normal perfusion parameters. CONCLUSIONS: Computed tomography angiography is a noninvasive and reliable tool for evaluating patients with EC-IC bypass. Perfusion CT allows monitoring of hemodynamic changes after bypass surgery. The combination of both modalities enables noninvasive anatomical and functional analysis of superficial temporal artery-middle cerebral artery anastomoses using a single CT protocol. Hemodynamic evaluation of patients with occlusive cerebrovascular disease before and after surgery may improve the prediction of outcome and may help identify patients in whom a bypass procedure can be performed.
File Format	HTM / HTML
ISSN	00223085
e-ISSN	19330693
Journal	Journal of Neurosurgery
Issue Number	4
Volume Number	114
Language	English
Publisher	American Association of Neurological Surgeons
Publisher Date	2011-04-01
Publisher Place	United States
Access Restriction	Open
Subject Keyword	Discipline Neurosurgery Angiography, Digital Subtraction Cerebral Angiography Cerebrovascular Disorders Surgery Tomography, X-ray Computed Vascular Grafting Anastomosis, Surgical Cerebral Infarction Cerebrovascular Circulation Physiology Cysteine Analogs & Derivatives Monitoring, Intraoperative Organotechnetium Compounds Radiopharmaceuticals Tomography, Emission-computed, Single-photon
Content Type	Text
Resource Type	Article
Subject	Neurology (clinical) Surgery

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Perfusion CT scanning and CT angiography in the evaluation of extracranial-intracranial bypass grafts.

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