A novel protocol for three-dimensional rotational venography with low-dose contrast media in preoperative angiography of brain tumours

The most appropriate imaging protocol for three-dimensional rotational venography (3D RV) has not been established. The aim of this study was to optimise the protocol for 3D RV with low-dose contrast media using time–density curve analysis.

Twenty-five consecutive patients with brain tumours who received preoperative assessment with 3D RV were retrospectively collected and included in this study. To optimise the imaging delay time of 3D RV with low-dose contrast media, time–density curve analysis was performed on two-dimensional conventional angiography. The image quality for depicting cortical veins and venous sinuses was compared to that of magnetic resonance (MR) venography in five cases.

A total of 27 3D RVs were performed in 25 patients. The time–density curves of cortical veins were different from those of cerebral arteries or sinuses. The mean time to peak of cortical veins was significantly longer than the time to peak of cerebral arteries (2.47 ± 0.35 seconds vs. 6.44 ± 1.14 seconds; p < 0.0001) and shorter than the time to peak of venous sinuses (6.44 ± 1.14 seconds vs. 8.18 ± 1.12 seconds; p < 0.0001). The optimal imaging delay time could be determined as the phases in which cortical arterial opacities disappeared and cortical veins started to appear. The mean dose of injected contrast media was 5.3 mL. The image quality of cortical veins in 3D RV was superior to that in MR venography in all cases.

Three-dimensional RV with low-dose contrast media was useful for the preoperative assessment of cortical veins in patients with brain tumours.