4D-CT angiography with arterial- and venous-phase anatomical pre-surgical approaches in cases with head and neck neoplasms.

Purpose: The relationship between neoplasm and its surrounding vascular structure is essential to the following clinical treatment plan. In this study, 4D computed tomography angiography (4D-CTA) with a wide scan range and dynamic phases of arteriography and venography was used to describe detailed anatomical information for pre-surgical approaches.

Materials And Methods: From January 2011 to February 2012, we subjected 13 patients with head and neck neoplasms to 4D-CTA. 4D-CTA was performed by a multidetector computed tomography (MDCT) scanner of 320 detectors. The parameters were set to a 0.5 mm section thickness, at 0.5 second per rotation, 80 kV and 150 mA. The scan range was set depending on the tumor size, with a maximal setting of 16 cm. A 30 mL contrast medium with 60 mL saline was injected at the rate of 5-7 mL per second based on the vascular patency, scanning every 2 seconds from the 16th to the 28th second after contrast injection.

Results: The vasculature surrounding the tumors was successfully illustrated in all cases. The 4D-CTA provided detailed vascular information that was compatible with the surgical and angiographic findings.

Conclusion: 4D-CTA with a wide scan range and precise injection timing methods facilitated an anatomical approach to tumor-related vascular structures, providing detailed vascular information. This non-invasive technique may be useful for evaluating neoplasms and developing treatment plans, as an alternative to conventional angiography.