CT Angiography

CT Angiography

Angiography can assist in surgical planning and in estimating the response of the tumour to preoperative chemotherapy. High-grade osteosarcomas promote extensive neovacularization and thus enhance with contrast medium. This enhancement, referred to as “tumour blush”, usually reflects viable tumor. The complete disappearance of tumor vascularity after preoperative chemotherapy correlates with a good treatment response. Biplanar angiography accurately determines the relationship of vessels to the tumor, along with the vascular displacement that occurs with a large soft tissue component. Vascular anomalies can also be detected, which is especially important for resection of proximal tibial tumors, in which the anterior tibial artery is routinely ligated. Arteriography is essential to ensure the presence and patency of the posterior tibial artery before ligation of the anterior tibial artery.

Recently selective transcatheter tumor embolization for highly vascular tumors especially in inaccessible sites or to reduce the risk of massive bleeding before surgery can be used as in giant cell tumor or aneurysmal bone cyst in the pelvis.

Also selective transcatheter delivery of chemotherapy inside the tumor can be used to maximize the number of the candidates suitable for limb salvage but is used beside the systemic chemotherapy.

axial CT cuts showing rotation of the bundle

angiogram cuts showing displacement and rotation of the bundle without infiltration


angiogram showing segment disappearance of the bundle and infiltration.

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