3-DIMENSIONAL COMPUTED TOMOGRAPHIC ANGIOGRAPHY IN THE PREOPERATIVE EVALUATION OF CEREBROVASCULAR LESIONS

ALTHOUGH THREE-DIMENSIONAL COMPUTED tomographic angiography was develo ped as a screening tool for use in patients with suspected cerebrovasc ular disease, this imaging modality has also proven to be of value in surgical planning for patients with large or unusual vascular lesions of the brain. The three-dimensional images generated by this technique yield valuable information regarding the size and configuration of in tracranial aneurysms and vascular malformations, the presence and exte nt of intra-aneurysmal thrombus, the relationship of the vascular lesi on to other cerebrovascular or skeletal structures, aneurysm wall thic kness, and the presence and orientation of an aneurysm neck. The use o f three-dimensional computed tomographic angiography in representative cases of patients with large or unusual cerebrovascular lesions is pr esented. It has been our experience that this imaging modality display s anatomical information that is not readily available from standard, intra-arterial angiography, provides better detail for surgical planni ng than magnetic resonance angiography, and is less expensive than eit her of these other imaging modalities.