Benefit of Advanced 3D DSA and MRI/CT Fusion in Neurovascular Pathology
Tomas Dobrocky, Marco Matzinger, Eike I. Piechowiak, Johannes Kaesmacher, Sara Pilgram‐Pastor, Johannes Goldberg, David Bervini, Tomas Klail, Vítor Mendes Pereira, Werner J. Z’Graggen, Andreas Raabe, Pasquale Mordasini, Jan Gralla
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.