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AJNR Awards, New Junior Editors, and more. Read the latest AJNR updates

Research ArticleNeurovascular/Stroke Imaging

IV Flat Detector CT Angiography in Flat Detector CT Image-Guided Minimally Invasive Surgery for the Treatment of Intracerebral Hypertensive Hemorrhage

Zhang Shu, Wei Wang, Yufa Qiu, Lihong Zhang, Yu Zheng, Jian Wang, Wenyi Li, Jiajia Ge, Ying Yu, Nan Lv and Chi Wang
American Journal of Neuroradiology May 2024, 45 (5) 581-587; DOI: https://doi.org/10.3174/ajnr.A8186
Zhang Shu
aFrom the Department of Stroke Center (S.Z., W.W., Y.Q., L.Z., C.W.), Taicang First People’s Hospital, Suzhou, China
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Wei Wang
aFrom the Department of Stroke Center (S.Z., W.W., Y.Q., L.Z., C.W.), Taicang First People’s Hospital, Suzhou, China
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Yufa Qiu
aFrom the Department of Stroke Center (S.Z., W.W., Y.Q., L.Z., C.W.), Taicang First People’s Hospital, Suzhou, China
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Lihong Zhang
aFrom the Department of Stroke Center (S.Z., W.W., Y.Q., L.Z., C.W.), Taicang First People’s Hospital, Suzhou, China
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Yu Zheng
bDepartment of Intervention (Y.Z., J.W.), Taicang First People’s Hospital, Suzhou, China
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Jian Wang
bDepartment of Intervention (Y.Z., J.W.), Taicang First People’s Hospital, Suzhou, China
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Wenyi Li
cAdvanced Therapies (W.L., J.G.), Siemens Healthineers Ltd., Shanghai, China
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Jiajia Ge
cAdvanced Therapies (W.L., J.G.), Siemens Healthineers Ltd., Shanghai, China
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  • ORCID record for Jiajia Ge
Ying Yu
dDepartment of Neurosurgery (Y.Y., N.L.), Changhai Hospital, Second Military Medical University, Shanghai, China
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Nan Lv
dDepartment of Neurosurgery (Y.Y., N.L.), Changhai Hospital, Second Military Medical University, Shanghai, China
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  • ORCID record for Nan Lv
Chi Wang
aFrom the Department of Stroke Center (S.Z., W.W., Y.Q., L.Z., C.W.), Taicang First People’s Hospital, Suzhou, China
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  • FIG 1.
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    FIG 1.

    Needle path planning and puncture guidance on the ivFDCTA image using syngo Needle Guidance software. Hemorrhage in the left basal ganglia. A puncture needle path was planned by defining the skull entry point and hematoma target point. The final puncture entry point (B) was adjusted to 1 cm before the first planning (A) to avoid the intracranial vascular cluster at the temporal side (red arrow).

  • FIG 2.
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    FIG 2.

    Monitoring of intraoperative hematoma evacuation under FDCT. The patient had an estimated hematoma volume of 45 mL. A, Discharge of 10 mL from the first hematoma. B, Laser crosshair indicated the second puncture entry point. C, A second puncture was performed, and the needle position was confirmed under FDCT. A total estimated volume of 25 mL of hematoma was aspirated. D, Postoperative CT shows a residual hematoma of 10 mL.

  • FIG 3.
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    FIG 3.

    Flow chart of the ivFDCTA- and FDCT-guided HICH evacuation.

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    FIG 4.

    IV 3D DSA image.

Tables

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  • Basic characteristics and postoperative evaluation of all 36 patients

    Characteristics
    Age (mean) (yr)53 (SD, 12)
    Sex (male) (%)81%
    NIHSS score on admission (median)17 (SD, 6)
    Preoperative GCS score (mean)10 (SD, 2)
    GOS4.3 (SD, 0.8)
    90-Day mRS2.4 (SD, 1.1)
    Complications2.7%
    Days to discharge16.4 (SD, 5.3)
    • Note:—GCS indicates Glasgow Coma Scale; GOS, Glasgow Outcome Score.

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American Journal of Neuroradiology: 45 (5)
American Journal of Neuroradiology
Vol. 45, Issue 5
1 May 2024
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Cite this article
Zhang Shu, Wei Wang, Yufa Qiu, Lihong Zhang, Yu Zheng, Jian Wang, Wenyi Li, Jiajia Ge, Ying Yu, Nan Lv, Chi Wang
IV Flat Detector CT Angiography in Flat Detector CT Image-Guided Minimally Invasive Surgery for the Treatment of Intracerebral Hypertensive Hemorrhage
American Journal of Neuroradiology May 2024, 45 (5) 581-587; DOI: 10.3174/ajnr.A8186

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Flat Detector CTA for Hypertensive Hemorrhage
Zhang Shu, Wei Wang, Yufa Qiu, Lihong Zhang, Yu Zheng, Jian Wang, Wenyi Li, Jiajia Ge, Ying Yu, Nan Lv, Chi Wang
American Journal of Neuroradiology May 2024, 45 (5) 581-587; DOI: 10.3174/ajnr.A8186
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