Clinical utility and problems of three-dimensional CT imaging for diagnosis and surgery of skull base tumors

The purposes of this paper are: to describe the appearance of brain tumors, particularly skull base tumors, with three-dimensional CT imaging with helical scanning and to evaluate the usefulness and the problem of applying this method to assess skull base tumors for surgery. Fifty-five patients with brain tumors, including 44 with skull base tumors, received an intravenous bolus injection of contrast material and were studied using helical CT (Xvigor) and work station system (Xtension). 3-D CT images revealed the relationship between skull base tumors with surrounding bony and vascular structures clearly, quickly, and with minimal risk to the patients. The technique also revealed the extent of destructive changes of bony structures in the skull base tumors. In addition, in every patient, we were able to evaluate whether adjacent major arteries or veins were displaced or surrounded by the brain tumor with 3-D CT examinations. Skull base meningiomas were more clearly visible on 3-D CT images because they enhanced with contrast material more extensively than other skull base tumors. The evaluation of 3-D CT images prior to surgery has been useful for operative procedures in all of our patient with brain tumors. (author)