Naoki Kato1, Ichiro Yuki2, Shunsuke Hataoka3, Chihebeddine Dahmani4, Katharina Otani5, Yukiko Abe6, Shota Kakizaki7, Gota Nagayama8, Fumiaki Maruyama9, Ayako Ikemura10, Issei Kan11, Tomonobu Kodama12, Toshihiro Ishibashi13, Yuichi Murayama14. 1. Department of Neurosurgery, The Jikei University School of Medicine Tokyo, 3-25-8, Nishi-shinbashi, Minato-ku, Tokyo 105-8461, Japan. Electronic address: nao-kth@jikei.ac.jp. 2. Department of Neurosurgery, The Jikei University School of Medicine Tokyo, 3-25-8, Nishi-shinbashi, Minato-ku, Tokyo 105-8461, Japan; Department of Neurosurgery, University California Irvine School of Medicine, California, USA. Electronic address: ichiroyuki@gmail.com. 3. Department of Neurosurgery, The Jikei University School of Medicine Tokyo, 3-25-8, Nishi-shinbashi, Minato-ku, Tokyo 105-8461, Japan; Department of Neurosurgery, National Hospital Organization Yokohama Medical Center, Kanagawa, Japan. Electronic address: shunsukehataoka@gmail.com. 4. Technology Excellence, Mechatronic Products, Technology & Innovation, Siemens Healthcare GmbH, Allee am Röthelheimpark 15, Erlangen, Germany. Electronic address: chihebeddine.dahmani@siemens-healthineers.com. 5. AT Innovation Department, Siemens Healthcare K.K., Gate City West Tower, 1-11-1 Osaki, Shinagawa-ku, Tokyo, Japan. Electronic address: katharina.otani@siemens-healthineers.com. 6. Department of Radiology, The Jikei University Hospital, Tokyo, Japan. Electronic address: yukiko.abe.0727@gmail.com. 7. Department of Neurosurgery, The Jikei University School of Medicine Tokyo, 3-25-8, Nishi-shinbashi, Minato-ku, Tokyo 105-8461, Japan. Electronic address: skakizaki0916@gmail.com. 8. Department of Neurosurgery, The Jikei University School of Medicine Tokyo, 3-25-8, Nishi-shinbashi, Minato-ku, Tokyo 105-8461, Japan. Electronic address: gotanagayama88@yahoo.co.jp. 9. Department of Neurosurgery, The Jikei University School of Medicine Tokyo, 3-25-8, Nishi-shinbashi, Minato-ku, Tokyo 105-8461, Japan. Electronic address: fumimaru1016@gmail.com. 10. Department of Neurosurgery, The Jikei University School of Medicine Tokyo, 3-25-8, Nishi-shinbashi, Minato-ku, Tokyo 105-8461, Japan. Electronic address: ayako.udgw613@gmail.com. 11. Department of Neurosurgery, The Jikei University School of Medicine Tokyo, 3-25-8, Nishi-shinbashi, Minato-ku, Tokyo 105-8461, Japan. Electronic address: ikan@jikei.ac.jp. 12. Department of Neurosurgery, The Jikei University School of Medicine Tokyo, 3-25-8, Nishi-shinbashi, Minato-ku, Tokyo 105-8461, Japan. Electronic address: kodama@jikei.ac.jp. 13. Department of Neurosurgery, The Jikei University School of Medicine Tokyo, 3-25-8, Nishi-shinbashi, Minato-ku, Tokyo 105-8461, Japan. Electronic address: t-ishibashi@jikei.ac.jp. 14. Department of Neurosurgery, The Jikei University School of Medicine Tokyo, 3-25-8, Nishi-shinbashi, Minato-ku, Tokyo 105-8461, Japan. Electronic address: ymurayama@jikei.ac.jp.
Abstract
PURPOSE: To assess the benefit and radiation dose of four-dimensional (4D) digital subtraction angiography (DSA) - a time resolved three-dimensional (3D) DSA application - to evaluate the flow and architecture of aneurysms and vascular malformations. METHODS: All patients with cerebrovascular disease were considered who underwent 4D-DSA at our institution between January 2015 and February 2016. For the aneurysm patients, we evaluated the image quality in terms of the visualization of contrast flow in the aneurysm on a 3-point scale (excellent, fair and poor). Interrater agreement between two raters was estimated using Cohen's Kappa statistics. For the shunt disease patients, the additional information obtained from the 4D-DSA was described for each disease. The median radiation dose and volume of contrast medium required for the acquisitions were estimated. RESULTS: A total of 173 patients underwent 4D-DSA; 126 intracranial aneurysms, 10 arteriovenous malformations (AVM), 15 dural arteriovenous fistula (dAVF) and 22 other diseases. For aneurysm patients, excellent and fair visualization of the intra-aneurysmal flow was observed in 27.7%, 72.3%, and excellent (κ = 0.9) agreement between the raters was found. For AVM and dAVF patients, 4D-DSA clarified the complex vasculature by viewing the discrete time phase of contrast filling. Median radiation dose for intracranial lesions was 79.6 mGy for 6s 4D-DSA, and 175 mGy for 12s 4D-DSA. The median amount of contrast medium used was 18.0 ml for 6s 4D-DSA and 21.0 ml for 12s 4D-DSA. CONCLUSIONS: 4D-DSA provided additional information regarding intra-aneurysmal flow and contributed to detect different component of nidus or shunt points.
PURPOSE: To assess the benefit and radiation dose of four-dimensional (4D) digital subtraction angiography (DSA) - a time resolved three-dimensional (3D) DSA application - to evaluate the flow and architecture of aneurysms and vascular malformations. METHODS: All patients with cerebrovascular disease were considered who underwent 4D-DSA at our institution between January 2015 and February 2016. For the aneurysmpatients, we evaluated the image quality in terms of the visualization of contrast flow in the aneurysm on a 3-point scale (excellent, fair and poor). Interrater agreement between two raters was estimated using Cohen's Kappa statistics. For the shunt disease patients, the additional information obtained from the 4D-DSA was described for each disease. The median radiation dose and volume of contrast medium required for the acquisitions were estimated. RESULTS: A total of 173 patients underwent 4D-DSA; 126 intracranial aneurysms, 10 arteriovenous malformations (AVM), 15 dural arteriovenous fistula (dAVF) and 22 other diseases. For aneurysmpatients, excellent and fair visualization of the intra-aneurysmal flow was observed in 27.7%, 72.3%, and excellent (κ = 0.9) agreement between the raters was found. For AVM and dAVF patients, 4D-DSA clarified the complex vasculature by viewing the discrete time phase of contrast filling. Median radiation dose for intracranial lesions was 79.6 mGy for 6s 4D-DSA, and 175 mGy for 12s 4D-DSA. The median amount of contrast medium used was 18.0 ml for 6s 4D-DSA and 21.0 ml for 12s 4D-DSA. CONCLUSIONS:4D-DSA provided additional information regarding intra-aneurysmal flow and contributed to detect different component of nidus or shunt points.
Authors: Aishwarya Raman; Manish Uprety; Maria Jose Calero; Maria Resah B Villanueva; Narges Joshaghani; Nicole Villa; Omar Badla; Raman Goit; Samia E Saddik; Sarah N Dawood; Ahmad M Rabih; Ahmad Mohammed; Tharun Yadhav Selvamani; Jihan Mostafa Journal: Cureus Date: 2022-06-09