Aims and objectives
To illustrate and to review usefulness of rotational DSA with dual volume visualization in the evaluation of neurovascular disease.
Summary:
Rotational DSA is useful imaging tool in the evaluation of neurovascular disease.
This exhibit illustrates basics including display modes and radiation dose,
and their clinical application in the evaluation of neurovascular disease inclulding intracranial aneurysm,
vascular malformation,
arteriovenous shunt,
and spinal vascular malformation.
Emphasize will be given to the usefulness of dual rotation with dual volume visualization.
After reviewing this exhibit,
the participant will be...
Methods and materials
# Contents :3D Rotational DSA (3D RA) with Dual Volume Visualization
Basics and Radiation Dose
Clinical application
Intracranial aneurysm
bAVM and dAVF
spinal Vascular malformation
# 3D Rotational Angiography (3D RA)
Performed using C-arm with rotation around the patient in a few seconds
Provides better understanding of vessel architecture of
1)Aneurysm :
Pretreatment: evaluating the potential for EVT,
finding a good working view,
performing accurate measurement1,
depict more aneurysms2…
During treatment: enable accurately determine stent position during stent assisted-coiling3,
evaluation of SAH in the angiographic...
Results
3D RA with DUAL VOLUME VISUALIZATION
ALSO HELPFUL WHEN …
# Aneurysm: Virtual Localization of Distal Dural Ring (Figure 5)
Visualization of virtual plane of DDR and localization of the paraclinoid ICA aneurysm in relation to the DDR is feasible with 3D RA
Lee et al.,
Neurointervention 2010;5:85-90
# Dural AVF
- Benefit of Rotational DSA
The presence of shunted venous pouch is a common angioarchitecture of transverse sinus dAVFs,
and identification of this pouch with rotational angiography would be useful for their treatment.
Kiyosue...
Conclusion
3D RA : Dual Volume Visualization
Ability to separately illustrate contrast-filled vessels vs mask with soft tissue,
bones,
calcification,
stents and coils
Radiation dose (dual rotation) similar to bi-plane evaluation of single vessel by 2D DSAs
Helpful in the evaluation of neurovascular ds including aneurysm,
dAVF,
spinal VM,
steno-occlusive disease
References
Anxlonnat et al.,
Radiology 2001;218:799-808
Van Rooij et al.,
AJNR 2008;29:976-979
Richter et al.
AJNR 2007;28:1902-1908
Doelken et al.,
Neuroradiology 2008;50:517-523
Kang et al.,
AJNR 2004;25:1463-1469,
Kiyosue et al.,
AJNR 2013; DOI:10.3174/ajnr.A3428
Brinjikji et al.,
AJNR 2009;30:831-834
Park et al.,
KCR2013 #SS262
Rumboldt et al.,
RSNA 2008
Lee et al.,
Neurointervention 2010;5:85-90
Kiyosue et al.,
AJNR 2013
Prestigiacomo et al.,
AJNR 2003;24:1429-1435