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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
DOI: 10.5603/FM.a2021.0133
·
Pubmed: 34966999
Affiliations
  1. Department of Descriptive and Clinical Anatomy, Medical University of Warsaw, Poland
  2. Department of Forensic Medicine, Medical University of Warsaw
  3. Institute of Mechanics and Computational Engineering, Faculty of Mechanical Engineering, Military University of Technology, Warsaw
  4. Institute of Materials Science and Engineering, Faculty of Advanced Technologies and Chemistry, Military University of Technology, Warsaw

open access

Ahead of Print
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 visualize structures smaller than 300 um in diameter. Perforating arteries, most of which measure 100-400 um 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 visualize perforators and compare it with microscopical and micro-CT pictures. Materials and methods: We have obtained six brainstem and seventeen 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 microscopical examinations were performed. Results: The median number of visualized 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 visualize 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 visualize structures smaller than 300 um in diameter. Perforating arteries, most of which measure 100-400 um 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 visualize perforators and compare it with microscopical and micro-CT pictures. Materials and methods: We have obtained six brainstem and seventeen 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 microscopical examinations were performed. Results: The median number of visualized 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 visualize 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

Ahead of Print

Article type

Original article

Published online

2021-12-15

Page views

226

Article views/downloads

125

DOI

10.5603/FM.a2021.0133

Pubmed

34966999

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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