CT - BRAIN ANGIOGRAPHY

         CT SCAN BRAIN (ANGIOGRAPHY)

CT Brain Angiography (CTA Brain) is a radiological procedure that uses computed tomography and contrast injection to visualize the blood vessels in the brain, especially arteries. It helps in diagnosing vascular abnormalities of the cerebral cirAcquisition



🧠 1. Definition

CT Brain Angiography (CTA) is an advanced imaging technique to evaluate intracranial arteries and veins, including:

  • Circle of Willis
  • Cerebral arteries (ACA, MCA, PCA)
  • Venous sinuses (if venous CTA is done)

It is faster and less invasive than conventional catheter angiography.

✅ 2. Indications

  • Aneurysms
  • Arteriovenous malformations (AVMs)
  • Acute stroke (to detect vessel occlusion)
  • Intracranial stenosis or thrombosis
  • Vascular tumors
  • Head trauma (to assess vascular injury)
  • Follow-up after clipping/coiling of aneurysms
  • Pre-operative planning for neurosurgery

❌ 3. Contraindications

  • Allergy to iodinated contrast
  • Renal impairment (especially with eGFR < 30)
  • Uncontrolled hyperthyroidism
  • Pregnancy (use caution due to radiation)
  • Uncooperative patient (may need sedation)

👤 4. Patient Preparation

  • Explain the procedure and obtain consent.
  • Fasting: 4–6 hours if contrast is used.
  • IV access: 18–20G cannula in the antecubital vein.
  • Check kidney function (serum creatinine/eGFR).
  • Remove metallic objects near the head/neck.

⚙️ 5. Method / Procedure

  1. Patient positioning: Supine, head secured, no movement.
  2. Non-contrast CT Brain may be done first (for stroke/bleed).
  3. Contrast injection:
    • 50–70 mL iodinated contrast at 4–5 mL/sec.
    • Followed by a saline flush.
  4. Scan range: From aortic arch to vertex.
  5. Acquisition: Thin slices, multiplanar reformatting (MPR), Maximum Intensity Projection (MIP), and 3D volume rendering.

     6. Timing- Bolus Tracking (preferred): ROI placed in the ascending aorta or carotid artery; scan triggered at ~100–150 HU.

   7.Alternative: Fixed delay method (15–20 seconds post-injection).

6.Technical Parameters

Parameter Typical Values
kVp 100–120 kVp
mA (with AEC) Automated (based on patient size) or ~200–400 mA
Slice Thickness 0.5–0.625 mm (thin slices for 3D reconstruction)
Rotation Time 0.4–0.5 seconds
Pitch 0.75–1.00
Reconstruction 
                             		 0.5–1 mm axial, coronal, sagittal; MPR, MIP, 3D VR                                                                  

📸 7. Filming / Image Acquisisagitta's 




  • Axial, coronal, and sagittal reconstructions
  • 3D vascular maps
  • MIP images to highlight vessels
  • Save to PACS, label with patient info, contrast dose, date.

🛏️ 8. After Care

  • Monitor patient for contrast reactions (nausea, allergy).
  • Encourage oral hydration to flush out contrast.
  • Resume normal diet and activity.
  • Inform patient to report any delayed reaction (rash, itching, SOB).

🧠 9. Diseases Detected

  • Cerebral aneurysms
  • AVMs (arteriovenous malformations)
  • Ischemic stroke (vessel occlusion or stenosis)
  • Hemorrhagic stroke (secondary to aneurysm rupture)
  • Vasculitis
  • Venous sinus thrombosis (in venous CTA)
  • Dissection of intracranial arteries
  • Vascular tumors or hypervascular metastases


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