subject: New Neurovascular Imaging Technologies Revolutionize Diagnosis and Treatment Assessment [print this page] New Neurovascular Imaging Technologies Revolutionize Diagnosis and Treatment Assessment
Neuroradiologists at Brigham and Women's Hospital are using new generations of computed tomography scanners to provide more advanced evaluation for diagnosis and assessment of a patient's response to treatment, while offering alternatives to more invasive catheter-based angiography techniques.Brigham and Women's Hospital neuroradiologists Srinivasan Mukundan, Jr., MD, PhD, Chief of the Division of Neuroradiology at Brigham and Women's Hospital, and Geoffrey S. Young, MD in close collaboration with colleagues Stephen Ledbetter, MD, MPH, and Aaron Sodickson, MD, PhD, in the Division of Emergency Radiology are using a fleet of new, stateof-the-art computed tomography (CT) scanners to noninvasively perform whole-brain, dynamic, bone-subtraction CT angiography and CT perfusion studies for identifying blockages of large cerebral vessels and evaluating regional blood flow at the capillary level of the entire brain.Time-resolved, whole-brain dynamic CT angiography provides sequential images of the blood transiting the cerebral vasculature at less than half-second intervals. When combined with bone-subtraction techniques, these images are very similar to those obtained from catheter digital subtraction angiography. By processing this data in a sophisticated way, dynamic whole-brain CT perfusion images provide a three-dimensional assessment of cerebral blood flow within the brain tissue at the microscopic vessel level.Obtained in less than a minute, these images provide neuroradiologists with comprehensive assessment of the whole brain in a manner that was not previously possible. The bone-subtraction capabilities of these new instruments make it possible to pinpoint areas of concern near the skull base and to diagnose vascular disease with greater accuracy. Together, these technologies help neuroimaging specialists guide treatment decisions for patients with acute stroke, vascular malformations, and other diseases of the brain and blood vessels."These new technologies benefit patients by reducing the need to use invasive catheter angiography, with its inherent risk of stroke, for diagnosis and often in treatment follow-up. They also enable us to lower radiation and contrast doses, improve the speed and accuracy of diagnosis, and facilitate earlier intervention of neurological and neurosurgical emergencies," said Dr. Mukundan.Technologies utilized by neuroradiologists include:Dynamic volumetric 320-detector row computed tomography scanner The world's first whole organ volumetric CT scanner includes 320 rows of detectors each of 0.5 mm width resulting in coverage of a full 16 cm volume in a single rotation of less than one second. Brigham and Women's Hospital was one of the first major teaching hospitals in the nation to deploy this groundbreaking scanner;128-slice CT scanner Brigham and Women's Hospital has deployed two of these advanced scanners, one located in the Emergency Department to facilitate emergency neurovascular and coronary artery imaging. These scanners offer a wider area of coverage for brain perfusion analysis and allow bone subtraction angiography;Dual-source 64-slice CT scanner This scanner uses two X-ray tubes and two detectors, rotating around the patient up to three times a second, and is used in research intended to allow more precise classification of different tissues based on differential X-ray attenuation at different X-ray energies. Brigham and Women's Hospital has been an early adopter of this technology.The ability to access this range of new technologies allows neuroradiologists to tailor a scan prescription for each individual patient through selection of the most appropriate cutting-edge scanner and technique.Brigham and Women's Hospital's neuroscience center offers neurology services with the care & compassion you would expect from an organization that has been consistently ranked as one of America's best hospitals on the U.S. News & World Report Honor Roll, and one of the top neurology & neurosurgery providers in the country.
