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Alternative oblique head CT scanning technique reduces bone artifact and improves interpretability of brainstem anatomy

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Author(s): Sam Douglas Kampondeni | Gretchen Lano Birbeck | Robert J. Oostveen | Colleen Hammond | Michael James Potchen

Journal: Neurology International
ISSN 2035-8385

Volume: 2;
Issue: 1;
Start page: e14;
Date: 2010;
Original page

Keywords: artifact | single slice CT | sagittal oblique | brainstem | brain CT

ABSTRACT
Brainstem pathology due to infections, infarcts and tumors are common in developing countries, but neuroimaging technology in these resource-poor settings is often limited to single slice, and occasionally spiral, CT. Unlike multislice CT and MRI, single slice and spiral CT are compromised by bone artifacts in the posterior fossa due to the dense petrous bones, often making imaging of the brainstem non-diagnostic. With appropriate head positioning, the petrous ridges can be avoided with 40˚ sagittal oblique scans parallel to either petrous ridge. We describe an alternative sagittal oblique scanning technique that significantly reduces brainstem CT artifacts thereby improving clarity of anatomy. With Inst­itutional Ethical approval, 13 adult patients were enrolled (5 males; 39%). All patients had routine axial brain CT and sagittal oblique scans with no lesions found. Images were read by 2 readers who gave a score for amount of artefact and clarity of structures in the posterior fossa. The mean artifact score was higher for routine axial images compared to sagittal oblique (2.92 vs. 1.23; P
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