Cranial CT Angiography in Pediatrics
Cranial CT Angiography in Pediatric Diagnostics
Introduction
Cranial CT Angiography (CTA) provides detailed vascular imaging of the intracranial and extracranial vessels in pediatric patients. This advanced imaging technique offers high-resolution vascular mapping with rapid acquisition times.
Key Points
- High spatial and temporal resolution
- Excellent vessel visualization
- 3D reconstruction capability
- Rapid acquisition time
- Requires iodinated contrast
- Radiation exposure consideration
Technical Requirements
Equipment Specifications
- Scanner Requirements
- Multi-detector CT (minimum 64-slice)
- High-speed rotation capability
- Advanced post-processing workstation
- Bolus tracking software
- Injection System
- Dual-head power injector
- Weight-based protocols
- Appropriate catheter sizing
- Saline flush capability
Protocol Optimization
Scanning Parameters
- Acquisition Parameters
- kVp: 80-100 based on weight
- mAs: Automatic exposure control
- Slice thickness: 0.5-0.625mm
- Pitch: 0.8-1.0
- Contrast Protocol
- Iodine concentration: 300-370 mg/mL
- Volume: 1.5-2.0 mL/kg
- Injection rate: 2-4 mL/sec
- Saline chase: 15-20 mL
Clinical Applications
Primary Indications
- Vascular Malformations
- Arteriovenous malformations
- Aneurysms
- Arteriovenous fistulas
- Developmental venous anomalies
- Acute Conditions
- Stroke assessment
- Vasospasm evaluation
- Traumatic vascular injury
- Venous sinus thrombosis
- Pre/Post-operative Assessment
- Surgical planning
- Post-intervention monitoring
- Bypass assessment
- Stent evaluation
Advanced Techniques
Post-processing Methods
- 3D Reconstructions
- Maximum intensity projection (MIP)
- Volume rendering (VR)
- Curved planar reformation (CPR)
- Surface shaded display (SSD)
- Advanced Analysis
- Vessel diameter measurements
- Stenosis quantification
- Automated vessel tracking
- Perfusion assessment
Pathological Findings
Common Abnormalities
- Congenital Conditions
- Circle of Willis variants
- Persistent fetal circulation
- Vascular dysplasias
- Developmental anomalies
- Acquired Pathologies
- Vasculitis
- Moyamoya disease
- Post-traumatic changes
- Atherosclerotic disease
Quality Optimization
Critical Factors
- Patient Preparation
- Adequate hydration
- Proper positioning
- Motion control strategies
- Contrast considerations
- Technical Optimization
- Timing optimization
- Coverage planning
- Resolution requirements
- Radiation dose management
Interpretation Guidelines
Systematic Approach
- Vessel Analysis
- Arterial phase assessment
- Venous phase evaluation
- Collateral circulation
- Perfusion patterns
- Pathology Detection
- Stenosis/occlusion
- Aneurysm characteristics
- Malformation analysis
- Variant anatomy
Safety Considerations
- Radiation Protection
- ALARA principles
- Protocol optimization
- Shielding techniques
- Dose monitoring
- Contrast Safety
- Renal function assessment
- Allergic reaction protocols
- Extravasation prevention
- Emergency preparedness
