320-Row Multidetector CT Angiography in the Detection of Critical Cerebrovascular Anomalies

2016 ◽  
Vol 43 (4) ◽  
pp. 543-548
Author(s):  
Julien Hébert ◽  
Federico Roncarolo ◽  
Donatella Tampieri ◽  
Maria delPilar Cortes
Keyword(s):  
Digital Subtraction Angiography ◽  
Cerebral Angiography ◽  
Multidetector Ct ◽  
Unruptured Aneurysm ◽  
Vascular Pathology ◽  
Vascular Lesions ◽  
Digital Subtraction ◽  
Montreal Neurological Institute ◽  
Cerebrovascular Lesions ◽  
Quality Imaging

AbstractBackground: The acquisition of a new 320-row multidetector computed tomography angiography (CTA) scanner at the Montreal Neurological Institute and Hospital has provided higher quality imaging with less radiation exposure and shorter time of acquisition. However, its reliability has not been fully proven in critical vascular lesions when it comes to replacing a more invasive examination such as cerebral angiography. We wished to validate the accuracy of this equipment to investigate four common indications for patients to undergo conventional digital subtraction angiography: subarachnoid hemorrhage, vasospasm, unusual intracerebral hemorrhage, and unruptured aneurysm. Methods: Radiological reports and relevant imaging from 82 consecutive subjects who underwent a 320-row multidetector CTA followed by cerebral angiography from February 2010 to February 2014 were retrospectively analysed. A total of 102 cerebrovascular anomalies were found. Reports from both imaging modalities were compared to determine the diagnostic accuracy of CTA. Results: The overall sensitivity and specificity of 320-row multidetector CTA for detecting cerebrovascular abnormalities were, respectively, 97.60% and 63.20%. Similar results were obtained for all four categories of clinical indications. Conclusion: Results obtained from CTA were consistent with those obtained on digital subtraction angiography regardless of the vascular pathology. To our knowledge, this study is the first validating the accuracy of 320-row CTA in diagnosing critical cerebrovascular lesions.

Frameless neuronavigation based only on 3D digital subtraction angiography using surface-based facial registration

2014 ◽  
Vol 121 (3) ◽  
pp. 745-750 ◽  
Author(s):  
David A. Stidd ◽  
Joshua Wewel ◽  
Ali J. Ghods ◽  
Stephan Munich ◽  
Anthony Serici ◽  
...  
Keyword(s):  
Digital Subtraction Angiography ◽  
Vascular Anatomy ◽  
Water Soluble ◽  
Vascular Lesions ◽  
Digital Subtraction ◽  
Cerebrovascular Lesions ◽  
Data Set ◽  
Surface Anatomy ◽  
Neuronavigation System ◽  
Image Set

Object Cerebrovascular lesions can have complicated abnormal anatomy that is not completely characterized by CT or MR angiography. Although 3D rotational angiography provides superior spatial and temporal resolution, catheter angiograms are not easily registered to the patient, limiting the use of these images as a source for neuronavigation. However, 3D digital subtraction angiography (DSA) contains not only vascular anatomy but also facial surface anatomy data. The authors report a novel technique to register 3D DSA images by using only the surface anatomy contained within the data set without having to fuse the DSA image set to other imaging modalities or use fiducial markers. Methods A cadaver model was first created to assess the accuracy of neuronavigation based on 3D DSA images registered by facial surface anatomy. A 3D DSA scan was obtained of a formalin-fixed cadaver head, with acquisitions of mask and contrast runs. The right common carotid artery was injected prior to the contrast run with a 45% contrast solution diluted with water-soluble red liquid latex. One week later, the head was registered to a neuronavigation system loaded with the 3D DSA images acquired earlier using facial surface anatomy. A right pterional craniotomy was performed and 10 different vascular landmarks were identified and measured for accuracy using the neuronavigation system. Neuronavigation based only on 3D DSA was then used to guide an open clipping procedure for a patient who presented with a ruptured distal lenticulostriate aneurysm. Results The accuracy of the measurements for the cadaver model was 0.71 ± 0.25 mm (mean ± SE), which is superior to the 1.8–5 mm reported for neuronavigation. The 3D DSA–based navigation-assisted surgery for the distal lenticulostriate aneurysm aided in localization, resulting in a small craniotomy and minimal brain dissection. Conclusions This is the first example of frameless neuronavigation based on 3D catheter angiography registered by only the surface anatomy data contained within the 3D DSA image set. This is an easily applied technique that is beneficial for accurately locating vascular pathological entities and reducing the dissection burden of vascular lesions.

scholarly journals Clinical and Radiation Diagnosisof Renal Arteriovenous Malformation

2017 ◽  
pp. 53-61
Author(s):  
A. N. Askerova
Keyword(s):  
Arteriovenous Malformation ◽  
Digital Subtraction Angiography ◽  
Arteriovenous Malformations ◽  
Multidetector Ct ◽  
Accurate Information ◽  
Digital Subtraction ◽  
Ct Scanner ◽  
Medical Systems ◽  
Iodinated Contrast ◽  
Renal Arteriovenous Malformation

Purpose:to analyze the results of preoperative diagnosis and treatment of patients with renal arteriovenous malformation and compare them with the literature data.Materials and methods.5 patients with renal arteriovenous malformations were examined for the period from 2014 to2016 in the FSBI "A.V. Vishnevsky Institute of Surgery» MH RF, where simultaneously there are clinical departments of urology and vascular surgery, 4 of them were treated. All patients were female. The mean age was 31.8 ± 6.7 years (24–41 years). Ultrasound was done to all the patients in B-mode followed by a duplex scan using an abdominal 2–4 MHz convex. MDCT was performed in 4 patients out of 5. Patients underwent multiphase examination on a multidetector CT-scanner Philips Brilliance iCT-256 and Brilliance CT-64 (Philips Medical Systems (Cleveland) with the 120 kV and 100 kV protocols and an intravenous injection of the iodinated contrast agent. Digital subtraction angiography was performed in 3 patients.Results.One-sided lesion occurred in four cases (3 of them (60%) right-sided and 1 (20%) left-sided), in one patient (20%) arteriovenous malformation was bilateral As a result of the analysis of our own material and literature data, the diagnostic criteria of renal arteriovenous malformations according to ultrasound, MDCT and digital subtraction angiography were studied in detail. The results of the examinations of 5 patients with demonstration of ultrasound, MDCT and angiographic images are presented with the visualization of the characteristic features of renal AVM. In addition, the treatment options for such patients with the possibility of preserving the kidney are described.Conclusion.Duplex scanning is an effective method of diagnosis and postoperative follow-up of patients with renal arteriovenous malformations. Preoperative computed tomography and selective digital subtraction angiography provide accurate information about the renal angioarchitectonics and AV-shunts for choosing the treatment tactics and planning the surgical intervention. 

scholarly journals Initial Clinical Trial of Robot of Endovascular Treatment with Force Feedback and Cooperating of Catheter and Guidewire

2018 ◽  
Vol 2018 ◽  
pp. 1-10
Author(s):  
Yuhua Jiang ◽  
Keyun Liu ◽  
Youxiang Li
Keyword(s):  
Clinical Trial ◽  
Clinical Practice ◽  
Endovascular Treatment ◽  
Digital Subtraction Angiography ◽  
Cerebral Angiography ◽  
Force Feedback ◽  
Digital Subtraction ◽  
Robot System ◽  
Bilateral Carotid ◽  
Blood Routine

To evaluate the feasibility and safety of the robot of endovascular treatment (RobEnt) in clinical practice, we carried out a cerebral angiography using this robot system. We evaluated the performance of application of the robot system to clinical practice through using this robotic system to perform the digital subtraction angiography for a patient who was suspected of suffering intracranial aneurysm. At the same time, through comparing the postoperative head nuclear magnetic and blood routine with the preoperative examination, we evaluated the safety of application of the robot system to clinical practice. We performed the robot system to complete the bilateral carotid artery and bilateral vertebral arteriography. The results indicate that there was no obvious abnormality in the patient’s cerebral artery. No obvious abnormality was observed in the examination of patients’ check-up, head nuclear magnetism, and blood routine after the digital subtraction angiography. From this clinical trial, it can be observed that the robot system can perform the operation of cerebral angiography. The robot system can basically complete the related observation indexes, and its accuracy, effectiveness, stability, and safety basically meet the requirements of clinical application in neurointerventional surgery.

Digital Subtraction Angiography Prior to an Amputation for Critical Limb Ischemia (CLI): An Expert Recommendation Statement From the CLI Global Society to Optimize Limb Salvage

2020 ◽  
Vol 27 (4) ◽  
pp. 540-546 ◽  
Author(s):  
Jihad A. Mustapha ◽  
Fadi A. Saab ◽  
Brad J. Martinsen ◽  
Constantino S. Pena ◽  
Thomas Zeller ◽  
...  
Keyword(s):  
Digital Subtraction Angiography ◽  
Limb Salvage ◽  
Critical Limb Ischemia ◽  
Limb Ischemia ◽  
Digital Subtraction ◽  
Global Society ◽  
Expert Recommendation ◽  
Below The Knee ◽  
Artery Disease ◽  
Quality Imaging

Despite recent guideline updates on peripheral artery disease (PAD) and critical limb ischemia (CLI) treatment, the optimal treatment for CLI is still being debated. As a result, care is inconsistent, with many CLI patients undergoing an amputation prior to what many consider to be mandatory: consultation with an interdisciplinary specialty care team and a comprehensive imaging assessment. More importantly, quality imaging is critical in CLI patients with below-the-knee disease. Therefore, the CLI Global Society has put forth an interdisciplinary expert recommendation for superselective digital subtraction angiography (DSA) that includes the ankle and foot in properly indicated CLI patients to optimize limb salvage. A recommended imaging algorithm for CLI patients is included.

scholarly journals Feasibility of ultra-low radiation dose digital subtraction angiography: Preliminary study in a simplified cerebral angiography phantom

2019 ◽  
Vol 25 (5) ◽  
pp. 589-595 ◽  
Author(s):  
Jun Young Maeng ◽  
Yunsun Song ◽  
Yu Sub Sung ◽  
Tae-Il Kim ◽  
Deok Hee Lee ◽  
...  
Keyword(s):  
Radiation Dose ◽  
Digital Subtraction Angiography ◽  
Cerebral Angiography ◽  
Signal To Noise Ratio ◽  
Standard Protocol ◽  
Digital Subtraction ◽  
Image Sharpness ◽  
Low Radiation Dose ◽  
Entrance Dose ◽  
Noise Ratio

Introduction The objective of this article is to evaluate the feasibility of cerebral digital subtraction angiography (DSA) using ultra-low radiation dose settings in a simplified cerebral angiography phantom. Materials and methods We created a silicone phantom capable of producing a simplified cerebral DSA. A total of 18 DSA sets were obtained with gradual six-step reduction of the detector entrance dose (DED) from 1.82 to 0.08 μGy per frame, while standard, postprocessing algorithm (PPA) and copper filter (0.3 mm) with PPA (CwP) algorithm reconstruction protocols were applied. We quantitatively compared their signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) and qualitatively analyzed the images' qualities in terms of image sharpness, contrast, and noise as investigated by five observers. Results The SNR and CNR, which decreased with lowering of the DED in the standard protocol group, were significantly compensated by using the PPA. The values were approximately double in the PPA (11.5 ± 2.9) and CwP (11.0 ± 2.5) groups compared with the standard (5.4 ± 1.1) group in the DED of 0.24 μGy per frame as well as in the other values. The total scores of the observers according to the protocols showed a tendency to decrease as the DED lowered. On average, the PPA (96.3 ± 34.6) and CwP (91.3 ± 29.9) groups yielded higher results than the standard protocol (83.7 ± 46.7). Conclusion Given that the current DED ranges from 1.82 to 3.60 μGy per frame for routine cerebral DSA, our results indicate that DED can be decreased to 15%–30% of the current dose level in vessels 2–4 mm in diameter if image-improvement algorithms are applied.

scholarly journals Transient Cortical Blindness after Digital Subtraction Angiography of Cerebral Vessels

2017 ◽  
Vol 14 (2) ◽  
pp. 36-38
Author(s):  
Shreeya Parajuli ◽  
Pravesh Rajbhandari ◽  
Sameer Acharya ◽  
Basant Pant
Keyword(s):  
Carotid Artery ◽  
Digital Subtraction Angiography ◽  
Cerebral Angiography ◽  
Carotid Artery Stenosis ◽  
Cortical Blindness ◽  
Artery Stenosis ◽  
Cerebral Vessels ◽  
Digital Subtraction ◽  
Transient Cortical Blindness ◽  
Rule Out

Transient blindness following cerebral angiography is a rare but known entity. We report a case of transient cortical blindness after cerebral angiography. The patient presented with is chemic stroke and the angiography was performed to rule out carotid artery stenosis. The patient, however, gradually regained his vision over a period of 3 days. This article is to understand one of the most unusual complications that may occur while performing angiography Nepal Journal of Neuroscience, Vol. 14, No. 2,  2017 Page: 36-38

Imaging of vascular pathology in hyperhomocysteinemic patients with digital subtraction angiography and magnetic resonance techniques

1997 ◽  
Vol 7 (8) ◽  
pp. 1335-1340
Author(s):  
D. G. Franken ◽  
J. O. Barentsz ◽  
F. M. J. Heijstraten ◽  
G. H. J. Boers ◽  
J. H. J. Ruijs
Keyword(s):  
Magnetic Resonance ◽  
Digital Subtraction Angiography ◽  
Vascular Pathology ◽  
Digital Subtraction

scholarly journals MDCT angiography of emergent, non-traumatic, upper extremity vascular lesions

2020 ◽  
Vol 93 (1116) ◽  
pp. 20190731
Author(s):  
Sameer Ahmed ◽  
Megan H Lee ◽  
Hannah Ahn ◽  
Elliot K. Fishman
Keyword(s):  
Upper Extremity ◽  
Multidetector Ct ◽  
Vascular Malformations ◽  
Maximum Intensity Projection ◽  
Vascular Pathology ◽  
Vascular Lesions ◽  
Emergency Setting ◽  
Mdct Angiography ◽  
Non Invasive

Timely, accurate diagnosis of upper extremity vascular pathology is critical for successful clinical and surgical management. Although the vast majority of upper extremity vascular injury is due to trauma, physicians in the emergency setting, including radiologists, must be familiar with vascular lesions from iatrogenic injury, thromboembolic disease, vascular malformations, and vasculitis. Non-invasive diagnostic imaging with multidetector CT (MDCT) angiography is often employed in the emergency department to evaluate patients with suspected vascular pathology of the upper extremity. Maximum intensity projection and volume rendering technique are two methods that are useful for evaluating vasculature. In addition, dual-energy MDCT is useful in that it allows for the generation of iodine-selective images and bone subtracted images. These techniques can be used to create images that simulate catheter angiograms. In this article, we will discuss the role of MDCT angiography in the diagnosis and management of emergent non-traumatic vascular lesions of the upper extremity.

scholarly journals Assessment of occlusive disease of lower extremity arteries on the basis of anatomic region: Value of 128-slice multidetector CT angiography in comparison with digital subtraction angiography

2017 ◽  
Vol 12 (4) ◽  
pp. 179-186
Author(s):  
Roshan Pangeni ◽  
Ping Han ◽  
Feng Pan ◽  
Laxmi Pangeni Lamsal ◽  
Zhen Zhang ◽  
...  
Keyword(s):  
Positive Predictive Value ◽  
Lower Extremity ◽  
Digital Subtraction Angiography ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Multidetector Ct ◽  
Digital Subtraction ◽  
Significant Difference ◽  
Arterial Occlusive Diseases ◽  
Sensitivity Specificity

Background & Objectives: The Previous studies of multidetector CT (MDCT) of the lower extremities for the detection of peripheral vascular disease showed high diagnostic accuracy but were performed with older generation systems. Our study aimed at assessing the diagnostic value of 128 MDCTA compared with that of digital subtraction angiography (DSA) in the grading of focal arterial disease of lower extremity arteries on the basis of anatomic regions.Materials & Methods: Forty-two patients with peripheral arterial occlusive diseases underwent both MDCTA and DSA. Lower extremity arteries depicted at MDCTA and DSA were graded separately for the degree of stenosis into 3 anatomic regions and 33 segments. Grading by MDCTA and DSA was done independently. Homogeneity analysis was used between MDCTA and DSA measurements in each patient. The sensitivity, specificity, positive predictive value and negative predictive value for detection of stenotic lesions were calculated for all anatomic regions, with findings at DSA used as the reference standard. Results: No statistically significant difference (P>.05) between DSA and MDCTA was present in Aorto-iliac and poplitiofemoral regions while there was statistically significant difference (P<.05) in the infrapopliteal region. The Sensitivity, Specificity, Positive Predictive Value and Negative Predictive Value based on a reading of MDCTA were 84.3%, 93.8%, 89.4% and 90.6% for aorto-iliac 86.6%, 94.7%, 84.1% and 94.7% for poplitiofemoral and 95.7%, 86.1%, 85.6% and 95.9% for infra-popliteal region respectively.Conclusion: MDCTA is excellent alternative in diagnosing lower extremity arterial occlusive diseases above the knee. DSA remains better on illustrating distal runoff vessels.

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