Ni-22 improved delineation of the superficial cerebral venous system in brain ct angiography by ultrahigh-resolution ct for assisting brain tumor surgery

Abstract BACKGROUND In brain CT angiography (CTA) for assisting brain tumor surgery, delineation of the superficial cerebral venous system is critical for selecting the optimal surgical approach. This delineation is, however, limited using conventional CT scanners, including an area-detector CT (ADCT) scanner, due to their insufficient spatial resolution. Since March 2017, a state-of-the-art ultrahigh-resolution CT (UHRCT) scanner has been clinically available to improve in- and through-plane spatial resolution compared with conventional CT scanners, mainly due to smaller slice thickness from 0.5 mm to 0.25 mm, larger channel number from 896 to 1792, and smaller x-ray focus from 0.9 x 0.8 mm to 0.4 x 0.5 mm.PurposeWe assessed usefulness of UHRCT to improve delineation of the superficial cerebral venous system in brain CTA for assisting brain tumor surgery compared with conventional ADCT. METHODS We retrospectively enrolled patients with intra- and/or extra-axial brain tumors who underwent preoperative brain CTA for assisting brain tumor surgery by UHRCT or ADCT using our routine technique and generated the CTA to delineate the superficial cerebral venous system using the same technique. Two reviewers by consensus subjectively counted the number of the superficial sylvian veins and the cortical veins draining into these veins and the maximal bifurcation order of the cortical veins draining into the superior sagittal sinus. We compared these numbers and the maximal bifurcation order in the CTA between the UHRCT and ADCT groups using the intraoperative findings as the reference. RESULTS The numbers and the maximal bifurcation order in the UHRCT group were significantly greater and more accurate than those in the ADCT group. CONCLUSIONS Use of UHRCT can be clinically useful for better delineating the superficial cerebral venous system in brain CTA and assisting brain tumor surgery.