Benefit of Advanced 3D DSA and MRI/CT Fusion in Neurovascular Pathology

Clin Neuroradiol. 2023 Sep;33(3):669-676. doi: 10.1007/s00062-022-01260-0. Epub 2023 Feb 6.

Abstract

Digital subtraction angiography provides excellent spatial and temporal resolution; however, it lacks the capability to depict the nonvascular anatomy of the brain and spinal cord.A review of the institutional database identified five patients in whom a new integrated fusion workflow of cross-sectional imaging and 3D rotational angiography (3DRA) provided important diagnostic information and assisted in treatment planning. These included two acutely ruptured brain arteriovenous malformations (AVM), a small superficial brainstem AVM after radiosurgery, a thalamic microaneurysm, and a spine AVM, and fusion was crucial for diagnosis and influenced further treatment.Fusion of 3DRA and cross-sectional imaging may help to gain a deeper understanding of neurovascular diseases. This is advantageous for planning and providing treatment and, most importantly, may harbor the potential to minimize complication rates. Integrating image fusion in the work-up of cerebrovascular diseases is likely to have a major impact on the neurovascular field in the future.

Keywords: AVM; Aneurysm; Image fusion; Intracerebral hemorrhage; Rotational angiography.

MeSH terms

  • Angiography, Digital Subtraction / methods
  • Humans
  • Imaging, Three-Dimensional / methods
  • Intracranial Arteriovenous Malformations* / diagnostic imaging
  • Intracranial Arteriovenous Malformations* / surgery
  • Magnetic Resonance Imaging
  • Tomography, X-Ray Computed