Spiral CT angiography for preoperative planning in patients with epigastric tumors : Comparison with arteriography

Spiral CT angiography (CTA) was performed on 22 patients for the preoperative assessment of epigastric tumors in comparison with intraarterial angiography. One hundred fifty milliliters of contrast material was administered with a flow of 4 ml/s. After a delay of 30 s, a spiral CT examination of the epigastrium was performed (slice thickness 3 mm, table feed 6 mm/s). Axial images were reconstructed at 2 mm increments. Postprocessing was performed with a maximum intensity projection and shaded surface display imaging program. Plain film arteriography was performed via a catheter inserted transfemorally and placed into the epigastric arteries. The following parameters were evaluated: visualization of the arteries and the portal vein and involvement of these vessels by disease. The vessels (22/22 = 100%) and variations (1/22 = 4.5%) were clearly identified with both techniques. Involvement was diagnosed by angiography 15 times compared with 22 findings by CTA. Concerning vessel anatomy, the correlation between both techniques was excellent and vessel involvement showed good correlation, especially when using the axial slices additionally. CTA has the potential to become a minimally invasive diagnostic tool for preoperative planning in epigastric tumors.