Clinical Advancements in Angiographic Imaging

Aquilion Case Study Giant Internal Carotid Aneurysm PROFILE: Patient complaining of severe headaches, visual disturbances and left-sided weakness with impaired coordination. FINDINGS: The subtracted DICOM volume is used to create multi-planar 3D Volume Rendered (3DVR) and Maximum Intensity Projection (MIP) images which clearly demonstrate this internal carotid aneurysm involving the right side. There is also decreased ﬂow to the anterior cerebral artery on the right side, involvement of the posterior communicating arteries on the right side and the origin of the right middle cerebral artery. SCAN PARAMETERS: Non-contrast helical scan is performed using 120 kV, 300 mA, 0.5 mm x 64. A second scan CTA Circle of Willis performed with 60 mls of intravenous contrast injected at 4 mls/second using the same scan parameters and SUREStart for bolus triggering. SURESubtraction software is used to subtract out the bone, creating a completely new subtracted DICOM volume. Image 1: Axial view of this 3DVR image demonstrates the rightsided aneurysm. Image 2: SURESubtraction software proves to be very valuable in clinically evaluating this aneurysm which is right in the skull base and would be obscured by bone in regular CTA. Image 3: Left lateral projection of the patient’s cerebral vasculature using an inverted 3D MIP technique, similar to traditional Digital Subtraction Angiography (DSA). Image 4: Coronal oblique plane MIP shows the decreased ﬂow of the right anterior cerebral artery and the aneurysm and its relationship to the carotid syphon, Posterior Communicating Aneurysm (PCA) and the Middle Cerebral Artery (MCA). Image 5: 3DVR view enlarged to show the middle cerebral artery on the right side and compression of the anterior cerebral artery caused by this right-sided aneurysm. Images courtesy of University of Florida Shands Image 6: Enlarged 3DVR posterior view of the aneurysm showing the relationship to right MCA and anterior communicating artery. 8 Oc tober 2 0 0 7 A public ation produced by Toshiba Medic al Sys t ems

Table of Contents Feed for the Digital Edition of Clinical Advancements in Angiographic Imaging

Contents PhaseXact™: Automatic Phase Cardiac Reconstruction Giant Internal Carotid Aneurysm Non-Contrast SSFP Time-SLIP Imaging: Renal Artery Stenosis Springhill Medical Center: A Partnership to Improve Patient Safety Anterior Cerebral Artery Aneurysm Right Coronary Artery (RCA) lesion with SUREPlaque analysis Neurovascular CTA: When every second counts

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