STEREOTAXIC NEUROSURGERY PLANNING WITH 3-D SPIRAL CT-ANGIOGRAPHY

Objective: To assess the feasibility and value of spiral CT angiograph y of the brain vessels for the planning of neurosurgical stereotactic interventions. Material and Methods: Fourty-two patients harboring cer ebral lesions underwent spiral CT angiography prior to stereotactic bi opsy. Thin spiral CT slices with a collimator slice thickeness of 1 mm and a pitch of 1 were used. Multiplanar reconstructions and maximum i ntensity projections (MIP) were obtained as well as 3-D tissue definit ion. Results: There was a sufficient visualization of vessels and of t heir relationship to the lesion. Tumor neovascularization was clearly demonstrated. Arteries could be shown separately. Stereotactic coordin ates of targets were chosen at a safe distance from the vessels and th e simulation of trajectories using the cine loop was made possible. In three cases the presence of a pathological vascularization warned aga inst a stereotactic biopsy. Conclusion: Spiral CT angiography seems to yield enough topographical information for the accurate planning of s tereotactic surgery for brain lesions. CT angiography with the helical technique is rapid and less invasive than digital subtraction angiogr aphy.