MDCT Compared with Digital Subtraction Angiography for Assessment of Lower Extremity Arterial Occlusive Disease:Importance of Reviewing Cross-Sectional Images

Digital subtraction angiography is the accepted reference for vascular imaging and grading of vessel stenosis. This test, however, is invasive, and uses nephrotoxic agents and ionizing radiation, making it a poor choice for first-line diagnosis of vascular disease. Duplex ultrasound is a widely used, non-invasive modality to perform vascular imaging, but this technique is operator dependent and has a high percentage of failed exams usually as a result of an inadequate acoustic window or patient habitus. Computed tomography angiography features non-invasive, cross-sectional imaging of the entire arterial and venous vasculature from head to toe, but this modality suffers similar limitations as digital subtraction angiography, and vessel wall calcifications may influence image analysis and rendering. Cardiovascular magnetic resonance (CMR) angiography has emerged as an excellent non-invasive angiographic substitute to digital subtraction angiography. Over the past three decades a series of CMR angiography approaches have been developed to pass the different hurdles inherently linked to vessel imaging. As such, dedicated CMR angiography sequences are nowadays available to study accurately the arterial and venous vessels in all parts of the human body. CMR angiography is either a standalone or can be part of a more comprehensive CMR approach including vessel wall imaging, quantitative flow imaging, and perfusion imaging of the end-organ. The aim of this chapter is to provide the reader with a comprehensive review of how CMR angiography is performed in clinical practice and how well this technique competes with other vascular imaging modalities.

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Characterizing tissue perfusion after lower extremity intervention using two-dimensional color-coded digital subtraction angiography

Journal of Vascular Surgery ◽

10.1016/j.jvs.2017.03.424 ◽

2017 ◽

Vol 66 (5) ◽

pp. 1464-1472 ◽

Cited By ~ 10

Author(s):

Ann H. Kim ◽

Andrew J. Shevitz ◽

Katherine L. Morrow ◽

Daniel E. Kendrick ◽

Karem Harth ◽

...

Keyword(s):

Lower Extremity ◽

Digital Subtraction Angiography ◽

Tissue Perfusion ◽

Two Dimensional ◽

Digital Subtraction

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Digital Subtraction Angiographic Study of Circle of Willis in Indian Population in a Tertiary Super-Specialty Hospital

Journal of National Institute of Neurosciences Bangladesh ◽

10.3329/jninb.v3i2.36774 ◽

2018 ◽

Vol 3 (2) ◽

pp. 99-105

Author(s):

Muhammad Abdul Momen Khan ◽

Shakir Husain ◽

Md Shohidul Islam ◽

Md Amir Hossain

Keyword(s):

Digital Subtraction Angiography ◽

Cerebrovascular Disorders ◽

Clinical Importance ◽

Uttar Pradesh ◽

Anatomical Variations ◽

Circle Of Willis ◽

Anterior Communicating Artery ◽

Digital Subtraction ◽

Anterior Circulation ◽

Cross Sectional

Background: Circle of Willis is an anastomotic polygon at the base of the brain which forms an important collateral network to maintain adequate cerebral perfusion. Changes in the normal morphology of the circle may causes the appearance and severity of symptoms of cerebrovascular disorders, such as aneurysms, infarctions and other vascular anomalies.Objectives: The aim of the present study was to analyses the anatomical variations of the circle of Willis by observing the variations in the cerebral arterial circle and was to clarify the clinical importance of these variations in certain forms of cerebrovascular diseases.Methodology: This cross-sectional study was conducted in the department of Neurointervention of Max Super-speciality Hospital, New Delhi, India and Neo multispeciality Hospital, Noida, Uttar Pradesh (UP), India during July 2016 to December 2016 for a period of six (6) months. Patients who were admitted in the Neurointervention department for digital subtraction angiography (DSA) were included in this study. The circle of Willis was then analyzed with the special reference to the complete or incomplete circle, any asymmetry in the configuration and variations in the size, and number of the component vessels, circle with multiple anomalies and absence, fenestration, duplication or triplication of any of the vessels.Results: Morphology and variations of the circle of Willis were studied in 74 patients undergone digital subtraction angiography (DSA). The normal pattern of circle of Willis was observed in 40(54.06%) cases and the remaining 34(45.94%) cases had one or more variations; however, 24(70.58%) cases had variations in the anterior circulation and 10(29.42%) cases had variations in the posterior circulation. 17(50%) cases had variations on the right side compared to 13(38.24%) variations on the left side. 4(11.76%) cases had variations in the anterior communicating artery. Incomplete circle of Willis were found 12(35.28%) cases. Multiple variations were observed in 11 cases (32.35%) in this study. In 4 cases anterior communicating artery aneurysms were observed.Conclusion: Variation of circle of Willis is common in this study of Indian population.Journal of National Institute of Neurosciences Bangladesh, 2017;3(2): 99-105

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