Department of Neuroradiology, Universitätsmedizin Göttingen, Goettingen, Germany.
Neurol Neurochir Pol. 2013 Jan-Feb;47(1):32-42. doi: 10.5114/ninp.2013.32996.
New angiographic devices with flat panel detectors allow cross-sectional imaging within the angiographic suite. In patients receiving external ventricular drainage (EVD) to manage hydrocephalus following subarachnoid haemorrhage (SAH), these may help evaluating the position of an EVD without moving the patient to a conventional computed tomography (CT) scanner. It could facilitate patients' management in a life-threatening status. This study therefore compares conventional CT with post-interventional flat panel detector angiographic CT (FDCT) referring to the determinability of an accurate EVD position.
Twenty patients with SAH received FDCT and conventional CT for primary assessment after EVD insertion. Three single-blinded raters compared both modalities and evaluated the image sufficiency for determining the EVD position, EVD tip, intracranial course and whether a contorted drainage tube could be detected.
FDCT was sufficient to detect a correct EVD position in 82.5% of the cases vs. 100% in conventional CT. Regarding the EVD tip, FDCT delivered at least 'good' results in 82.5% vs. 95% in conventional CT data. Determining the EVD intracranial course, FDCT provided at least 'good' data in 92.5% vs. 100% in conventional CT. For detecting tube contortion, FDCT provided at least 'good' results in 70% vs. 98% in conventional CT.
FDCT is a promising method to determine the correct position of an EVD in patients with SAH. Following a neuroradiological intervention, it facilitates the patients' management and renders additional transfers to conventional CT unnecessary in the majority of cases.
新型平板探测器血管造影设备可在血管造影室内进行横断面成像。在蛛网膜下腔出血（SAH）后接受外部脑室引流（EVD）以治疗脑积水的患者中，这些设备可能有助于在不移动患者至传统计算机断层扫描（CT）扫描仪的情况下评估 EVD 的位置。这可以在危及生命的情况下为患者的管理提供便利。因此，本研究比较了传统 CT 与介入后平板探测器血管造影 CT（FDCT），以评估确定 EVD 准确位置的能力。
20 例 SAH 患者在 EVD 插入后接受 FDCT 和常规 CT 进行初步评估。三名单盲评估者比较了两种方式，并评估了图像是否足以确定 EVD 位置、EVD 尖端、颅内走行以及是否可以检测到扭曲的引流管。
FDCT 在 82.5%的病例中足以检测到正确的 EVD 位置，而在常规 CT 中则为 100%。在 EVD 尖端方面，FDCT 在至少 82.5%的病例中提供了“良好”的结果，而在常规 CT 数据中则为 95%。确定 EVD 颅内走行时，FDCT 在 92.5%的病例中提供了至少“良好”的数据，而在常规 CT 中则为 100%。在检测管扭曲方面，FDCT 在 70%的病例中提供了至少“良好”的结果，而在常规 CT 中则为 98%。
FDCT 是一种确定 SAH 患者 EVD 正确位置的有前途的方法。在神经放射学干预后，它为患者的管理提供了便利，并使大多数情况下无需将患者转至传统 CT。
