open access

Vol 82, No 1 (2023)
Original article
Submitted: 2021-10-29
Accepted: 2021-11-28
Published online: 2021-12-15
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Standard clinical computed tomography fails to precisely visualise presence, course and branching points of deep cerebral perforators

R. Rzepliński1, M. Sługocki1, M. Kwiatkowska2, S. Tarka2, M. Tomaszewski3, M. Kucewicz3, K. Karczewski4, P. Krajewski2, J. Małachowski3, B. Ciszek1
·
Pubmed: 34966999
·
Folia Morphol 2023;82(1):37-41.
Affiliations
  1. Department of Descriptive and Clinical Anatomy, Medical University of Warsaw, Poland
  2. Department of Forensic Medicine, Medical University of Warsaw, Poland
  3. Institute of Mechanics and Computational Engineering, Faculty of Mechanical Engineering, Military University of Technology, Warsaw, Poland
  4. Institute of Materials Science and Engineering, Faculty of Advanced Technologies and Chemistry, Military University of Technology, Warsaw, Poland

open access

Vol 82, No 1 (2023)
ORIGINAL ARTICLES
Submitted: 2021-10-29
Accepted: 2021-11-28
Published online: 2021-12-15

Abstract

Background: Standard computed tomography (CT) images have earned a well-established position in neuroimaging. Despite that, CT is somehow limited by its resolution, which does not enable to distinctively visualise structures smaller than 300 μm in diameter. Perforating arteries, most of which measure 100–400 μm in diameter, supply important subcortical structures (thalamus, basal ganglia, internal capsule). Consequently, pathologies affecting these vessels (e.g. lacunar strokes) can have a devastating clinical outcome. The aim of our study was to assess standard CT’s ability to visualise perforators and compare it with microscopic and micro-CT pictures.
Materials and methods: We have obtained 6 brainstem and 17 basal ganglia specimens. We infused them with barium sulphate contrast medium administered into either vertebral or internal cerebral artery. After that, the specimens were fixed in formalin and subsequently a series of CT, micro-CT and microscopic examinations were performed.
Results: The median number of visualised perforators in brainstem and basal ganglia specimens was 8 and 3, respectively for CT and 18 and 7 for micro–CT (p < 0.05). Standard CT failed to clearly visualise branching points and vessels smaller than 0.25–0.5 mm (1–2 voxels) in diameter. Parallel vessels, like lenticulostriate arteries could not be differentiated in standard CT due to their proximity being smaller that the resolution.
Conclusions: Basing on our results, we infer that CT is a poor modality for imaging of the perforators, presenting both quantitative and qualitative flaws in contrast with micro-CT.

Abstract

Background: Standard computed tomography (CT) images have earned a well-established position in neuroimaging. Despite that, CT is somehow limited by its resolution, which does not enable to distinctively visualise structures smaller than 300 μm in diameter. Perforating arteries, most of which measure 100–400 μm in diameter, supply important subcortical structures (thalamus, basal ganglia, internal capsule). Consequently, pathologies affecting these vessels (e.g. lacunar strokes) can have a devastating clinical outcome. The aim of our study was to assess standard CT’s ability to visualise perforators and compare it with microscopic and micro-CT pictures.
Materials and methods: We have obtained 6 brainstem and 17 basal ganglia specimens. We infused them with barium sulphate contrast medium administered into either vertebral or internal cerebral artery. After that, the specimens were fixed in formalin and subsequently a series of CT, micro-CT and microscopic examinations were performed.
Results: The median number of visualised perforators in brainstem and basal ganglia specimens was 8 and 3, respectively for CT and 18 and 7 for micro–CT (p < 0.05). Standard CT failed to clearly visualise branching points and vessels smaller than 0.25–0.5 mm (1–2 voxels) in diameter. Parallel vessels, like lenticulostriate arteries could not be differentiated in standard CT due to their proximity being smaller that the resolution.
Conclusions: Basing on our results, we infer that CT is a poor modality for imaging of the perforators, presenting both quantitative and qualitative flaws in contrast with micro-CT.

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Keywords

perforating arteries, cerebral perforators, computed tomography, micro-computed tomography, cerebral circulation

About this article
Title

Standard clinical computed tomography fails to precisely visualise presence, course and branching points of deep cerebral perforators

Journal

Folia Morphologica

Issue

Vol 82, No 1 (2023)

Article type

Original article

Pages

37-41

Published online

2021-12-15

Page views

3308

Article views/downloads

875

DOI

10.5603/FM.a2021.0133

Pubmed

34966999

Bibliographic record

Folia Morphol 2023;82(1):37-41.

Keywords

perforating arteries
cerebral perforators
computed tomography
micro-computed tomography
cerebral circulation

Authors

R. Rzepliński
M. Sługocki
M. Kwiatkowska
S. Tarka
M. Tomaszewski
M. Kucewicz
K. Karczewski
P. Krajewski
J. Małachowski
B. Ciszek

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