Combination of Noninvasive Neurovascular Imaging Modalities in Stroke Patients: Patterns of Use and Impact on Need for Digital Subtraction Angiography

2013 ◽  
Vol 22 (7) ◽  
pp. e53-e58 ◽  
Author(s):  
Ameer E. Hassan ◽  
Nassir Rostambeigi ◽  
Saqib A. Chaudhry ◽  
Asif A. Khan ◽  
Haralabos Zacharatos ◽  
...  
Keyword(s):  
Digital Subtraction Angiography ◽  
Imaging Modalities ◽  
Digital Subtraction ◽  
Stroke Patients ◽  
Patterns Of Use ◽  
Neurovascular Imaging

Benefit of cone-beam computed tomography angiography in acute management of angiographically undetectable ruptured arteriovenous malformations

2013 ◽  
Vol 119 (4) ◽  
pp. 1015-1020 ◽  
Author(s):  
Jason P. Rahal ◽  
Adel M. Malek
Keyword(s):  
Digital Subtraction Angiography ◽  
Ct Angiography ◽  
Arteriovenous Malformations ◽  
Cone Beam Ct ◽  
Gamma Knife Radiosurgery ◽  
Imaging Modalities ◽  
Cone Beam ◽  
Digital Subtraction ◽  
Conventional Angiography ◽  
The Third

Object Ruptured arteriovenous malformations (AVMs) are a frequent cause of intracerebral hemorrhage (ICH). In some cases, compression from the associated hematoma in the acute setting can partially or completely occlude an AVM, making it invisible on conventional angiography techniques. The authors report on the successful use of cone-beam CT angiography (CBCT-A) to precisely identify the underlying angioarchitecture of ruptured AVMs that are not visible on conventional angiography. Methods Three patients presented with ICH for which they underwent examination with CBCT-A in addition to digital subtraction angiography and other imaging modalities, including MR angiography and CT angiography. All patients underwent surgical evacuation due to mass effect from the hematoma. Clinical history, imaging studies, and surgical records were reviewed. Hematoma volumes were calculated. Results In all 3 cases, CBCT-A demonstrated detailed anatomy of an AVM where no lesion or just a suggestion of a draining vein had been seen with other imaging modalities. Magnetic resonance imaging demonstrated enhancement in 1 patient; CT angiography demonstrated a draining vein in 1 patient; 2D digital subtraction angiography and 3D rotational angiography demonstrated a suggestion of a draining vein in 2 cases and no finding in the third. In the 2 patients in whom CBCT-A was performed prior to surgery, the demonstrated AVM was successfully resected without evidence of a residual lesion. In the third patient, CBCT-A allowed precise targeting of the AVM nidus using Gamma Knife radiosurgery. Conclusions Cone-beam CT angiography should be considered in the evaluation and subsequent treatment of ICH due to ruptured AVMs. In cases in which the associated hematoma compresses the AVM nidus, CBCT-A can have higher sensitivity and anatomical accuracy than traditional angiographic modalities, including digital subtraction angiography.

scholarly journals Comparing the Accuracy of Digital Subtraction Angiography, CT Angiography and MR Angiography at Estimating the Volume of Cerebral Aneurysms

2008 ◽  
Vol 14 (2) ◽  
pp. 173-177 ◽  
Author(s):  
M. Hanley ◽  
W.J. Zenzen ◽  
M.D. Brown ◽  
J.R. Gaughen ◽  
A.J. Evans
Keyword(s):  
Digital Subtraction Angiography ◽  
Ct Angiography ◽  
Mr Angiography ◽  
Clinical Decision Making ◽  
Cerebral Aneurysms ◽  
Error Rates ◽  
Imaging Modalities ◽  
Parent Artery ◽  
Digital Subtraction ◽  
True Variance

While there are many studies that compare imaging modalities in the detection of cerebral aneurysms there are no existing studies that compare two dimensional digital subtraction angiography (DSA), CT angiography (CTA) and MR angiography (MRA) in calculating the volume of cerebral aneurysms. This study will compare these imaging modalities on seven in-vitro models of known volume. Seven silicone models of cerebral aneurysms were chosen representing slight variations in geometric shape and size. The volume of each model was measured by weighing the amount of water required to fill the aneurysm to the parent artery. Contrast enhanced images of the models were taken with DSA, CTA and MRA. The images were interpreted by four independent readers and the volumes were calculated. The measured volumes from the water weight analysis were compared to the volumes calculated from the interpreter's measurements. The accuracy of DSA, CTA and MRA were compared using the percent of absolute and true variance from the measured volume. The average percent absolute variance for DSA was 14.3%, CTA was 16.8% and MRA was 18.6%. While these differences were minimal, comparing the percent of true variance demonstrated an average variance of −1.9% for DSA, 16.1% for CTA and −15.9% for MRA. Calculating the volume of cerebral aneurysms, while increasingly important, is difficult and error prone. It is important to understand the limitations and inherent errors before relying on calculated volumes in clinical decision-making. Regardless of imaging modality, one should consider error rates of 14–19% for calculating volume while keeping in mind the tendency for CTA to overestimate volume, MRA to underestimate volume and DSA to both under and overestimate equally.

scholarly journals Prognosis of ischemic stroke patients with or without collateralization after carotid stenosis

2018 ◽  
Vol 11 (4) ◽  
pp. 270-273
Author(s):  
Subash Kanti Dey ◽  
Md. Shahidullah ◽  
Anis Ahmed ◽  
Ahsan Habib ◽  
Abu Nasar Rizvi
Keyword(s):  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Carotid Stenosis ◽  
Digital Subtraction Angiography ◽  
P Value ◽  
Digital Subtraction ◽  
Stroke Patients

The objective of this study was to see the  association of the prognosis of ischemic stroke patients with or without collateralization after carotid stenosis. This study was conducted on 36 patients presenting with acute ischemic stroke who were going through digital subtraction angiography from March 2017 to March 2018. Collateralization status after unilateral or bilateral stenosis was evaluated. Modified ranking scale (mRS) score was  measured on the first day of the stroke and after three months. The disability of ischemic stroke patients was compared between patients who developed collateralization and who had not. Among them, 61.6% developed collateralization. Among the patients who developed collateralization after three months, 90.9% patients had mRS scale of ≤2 and who not developed collateralization, 85.7% patients had mRS scale of ≤2. In both the groups, the p value was <0.05. It can be concluded that carotid stenosed patients who suffered from ischemic stroke, most of the patients disability improved to some extents whether collateralization developed or not among the major vessels.

Evaluation of neurosonology versus digital subtraction angiography in acute stroke patients

2021 ◽  
Vol 91 ◽  
pp. 378-382
Author(s):  
Farhad Assarzadegan ◽  
Foroogh Mohammadi ◽  
Behnam Safarpour Lima ◽  
Behnam Mansouri ◽  
Seyed Hossein Aghamiri ◽  
...  
Keyword(s):  
Acute Stroke ◽  
Digital Subtraction Angiography ◽  
Digital Subtraction ◽  
Stroke Patients
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