Frameless neuronavigation based only on 3D digital subtraction angiography using surface-based facial registration

2014 ◽  
Vol 121 (3) ◽  
pp. 745-750 ◽  
Author(s):  
David A. Stidd ◽  
Joshua Wewel ◽  
Ali J. Ghods ◽  
Stephan Munich ◽  
Anthony Serici ◽  
...  
Keyword(s):  
Digital Subtraction Angiography ◽  
Vascular Anatomy ◽  
Water Soluble ◽  
Vascular Lesions ◽  
Digital Subtraction ◽  
Cerebrovascular Lesions ◽  
Data Set ◽  
Surface Anatomy ◽  
Neuronavigation System ◽  
Image Set

Object Cerebrovascular lesions can have complicated abnormal anatomy that is not completely characterized by CT or MR angiography. Although 3D rotational angiography provides superior spatial and temporal resolution, catheter angiograms are not easily registered to the patient, limiting the use of these images as a source for neuronavigation. However, 3D digital subtraction angiography (DSA) contains not only vascular anatomy but also facial surface anatomy data. The authors report a novel technique to register 3D DSA images by using only the surface anatomy contained within the data set without having to fuse the DSA image set to other imaging modalities or use fiducial markers. Methods A cadaver model was first created to assess the accuracy of neuronavigation based on 3D DSA images registered by facial surface anatomy. A 3D DSA scan was obtained of a formalin-fixed cadaver head, with acquisitions of mask and contrast runs. The right common carotid artery was injected prior to the contrast run with a 45% contrast solution diluted with water-soluble red liquid latex. One week later, the head was registered to a neuronavigation system loaded with the 3D DSA images acquired earlier using facial surface anatomy. A right pterional craniotomy was performed and 10 different vascular landmarks were identified and measured for accuracy using the neuronavigation system. Neuronavigation based only on 3D DSA was then used to guide an open clipping procedure for a patient who presented with a ruptured distal lenticulostriate aneurysm. Results The accuracy of the measurements for the cadaver model was 0.71 ± 0.25 mm (mean ± SE), which is superior to the 1.8–5 mm reported for neuronavigation. The 3D DSA–based navigation-assisted surgery for the distal lenticulostriate aneurysm aided in localization, resulting in a small craniotomy and minimal brain dissection. Conclusions This is the first example of frameless neuronavigation based on 3D catheter angiography registered by only the surface anatomy data contained within the 3D DSA image set. This is an easily applied technique that is beneficial for accurately locating vascular pathological entities and reducing the dissection burden of vascular lesions.

320-Row Multidetector CT Angiography in the Detection of Critical Cerebrovascular Anomalies

2016 ◽  
Vol 43 (4) ◽  
pp. 543-548
Author(s):  
Julien Hébert ◽  
Federico Roncarolo ◽  
Donatella Tampieri ◽  
Maria delPilar Cortes
Keyword(s):  
Digital Subtraction Angiography ◽  
Cerebral Angiography ◽  
Multidetector Ct ◽  
Unruptured Aneurysm ◽  
Vascular Pathology ◽  
Vascular Lesions ◽  
Digital Subtraction ◽  
Montreal Neurological Institute ◽  
Cerebrovascular Lesions ◽  
Quality Imaging

AbstractBackground: The acquisition of a new 320-row multidetector computed tomography angiography (CTA) scanner at the Montreal Neurological Institute and Hospital has provided higher quality imaging with less radiation exposure and shorter time of acquisition. However, its reliability has not been fully proven in critical vascular lesions when it comes to replacing a more invasive examination such as cerebral angiography. We wished to validate the accuracy of this equipment to investigate four common indications for patients to undergo conventional digital subtraction angiography: subarachnoid hemorrhage, vasospasm, unusual intracerebral hemorrhage, and unruptured aneurysm. Methods: Radiological reports and relevant imaging from 82 consecutive subjects who underwent a 320-row multidetector CTA followed by cerebral angiography from February 2010 to February 2014 were retrospectively analysed. A total of 102 cerebrovascular anomalies were found. Reports from both imaging modalities were compared to determine the diagnostic accuracy of CTA. Results: The overall sensitivity and specificity of 320-row multidetector CTA for detecting cerebrovascular abnormalities were, respectively, 97.60% and 63.20%. Similar results were obtained for all four categories of clinical indications. Conclusion: Results obtained from CTA were consistent with those obtained on digital subtraction angiography regardless of the vascular pathology. To our knowledge, this study is the first validating the accuracy of 320-row CTA in diagnosing critical cerebrovascular lesions.

Intraoperative Spinal Digital Subtraction Angiography: Technique and Results

Neurosurgery ◽  
2003 ◽  
Vol 52 (3) ◽  
pp. 603-609 ◽  
Author(s):  
Ludwig Benes ◽  
Jörg-Peter Wakat ◽  
Ulrich Sure ◽  
Siegfried Bien ◽  
Helmut Bertalanffy
Keyword(s):  
Digital Subtraction Angiography ◽  
Wound Closure ◽  
Vascular Malformations ◽  
Vascular Anatomy ◽  
Vascular Lesions ◽  
Digital Subtraction ◽  
Segmental Artery ◽  
Spinal Vascular Malformations ◽  
Clinical Records ◽  
Methodological Aspects

Abstract OBJECTIVE To evaluate technical and methodological aspects of intraoperative spinal digital subtraction angiography (ISDSA) in our clinical practice and to assess its practicability, safety, and accuracy for the surgical treatment of spinal vascular malformations. METHODS Between August 1997 and February 2002, a total of 30 patients were treated either surgically (n = 18) or endovascularly (n = 12) for spinal vascular lesions at our institution. The clinical records of five patients who underwent ISDSA were analyzed retrospectively. The thoracic segment was involved in three patients and the medullary cone in two. RESULTS ISDSA could be performed in four cases. In one patient, the segmental artery could not be probed sufficiently while the patient was prone. No complications occurred from the application of ISDSA. The method was beneficial for the neurosurgeon in all but one patient because the vascular anatomy of the malformation was shown with respect to the surgical approach, including the nidus, and immediate resection control could be performed before wound closure. The duration of the procedure was prolonged by 45 minutes on average. CONCLUSION ISDSA is safe and effective, especially in surgery for complex vascular and recurrent malformations. Benefits to the patient outweigh the additional expense and prolongation of the surgical procedure.

Preoperative imaging of cervical spine hemangioblastomas using three-dimensional fusion digital subtraction angiography

2006 ◽  
Vol 5 (1) ◽  
pp. 96-100 ◽  
Author(s):  
Daniel M. Sciubba ◽  
Gaurav G. Mavinkurve ◽  
Philippe Gailloud ◽  
Ira M. Garonzik ◽  
Pablo F. Recinos ◽  
...  
Keyword(s):  
Cervical Spine ◽  
High Resolution ◽  
Preoperative Evaluation ◽  
Three Dimensional ◽  
Vascular Anatomy ◽  
Reconstruction Algorithm ◽  
Vascular Supply ◽  
Vascular Lesions ◽  
Preoperative Imaging ◽  
Digital Subtraction

✓ Angiography is often performed to identify the vascular supply of hemangioblastomas prior to resection. Conventional two-dimensional (2D) digital subtraction (DS) angiography and three-dimensional (3D) DS angiography provides high-resolution images of the vascular structures associated with these lesions. However, such 3D DS angiography often does not provide reliable anatomical information about nearby osseous structures, or when it does, resolution of vascular anatomy in the immediate vicinity of bone is sacrificed. A novel angiographic reconstruction algorithm was recently developed at The Johns Hopkins University to overcome these inadequacies. By combining two separate sequences of images of bone and blood vessels in a single 3D representation, 3D fusion DS (FDS) angiography provides precise topographic information about vascular lesions in relation to the osseous environment, without a loss of resolution. In this paper, the authors present the cases of two patients with cervical spine hemangioblastomas who underwent preoperative evaluation with FDS angiography and then successful gross-total resection of their tumors. In both cases, FDS angiography provided high-resolution 3D images of the hemangioblastoma anatomy, including each tumor’s topographic relationship with adjacent osseous structures and the location and size of feeding arteries and draining veins. These cases provide evidence that FDS angiography represents a useful adjunct to magnetic resonance imaging and 2D DS angiography in the preoperative evaluation and surgical planning of patients with vascular lesions in an osseous environment, such as hemangioblastomas in the spinal cord.

Angiographic Detection and Characterization of “Cryptic Venous Anomalies” Associated With Spinal Cord Cavernous Malformations Using Flat-Panel Catheter Angiotomography

2012 ◽  
Vol 71 (suppl_1) ◽  
pp. ons125-ons132 ◽  
Author(s):  
Monica S. Pearl ◽  
James X. Chen ◽  
Lydia Gregg ◽  
Diego San Millàn ◽  
Allan Belzberg ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Digital Subtraction Angiography ◽  
Surgical Complication ◽  
Digital Subtraction ◽  
Flat Panel ◽  
Data Set ◽  
Intramedullary Spinal Cord ◽  
Cavernous Malformations ◽  
Venous Anomalies

BACKGROUND: Spinal cord cavernous malformations (CMs) are associated with 2 types of angiographically occult “cryptic venous anomalies,” which differ in location with respect to the spinal cord. The anatomic distinction between superficial and intramedullary is important in that the latter heighten the risks of CM resection. OBJECTIVE: To report the observations of both types of cryptic venous anomalies documented during spinal digital subtraction angiography enhanced with flat-panel catheter angiotomography (FPCA). METHODS: Spinal digital subtraction angiography enhanced with FPCA was performed in 2 adult patients with magnetic resonance imaging--documented intramedullary spinal cord CMs and prominent, nonspecific flow voids at the same levels. FPCA was obtained by selective injection of left T4 (case 1) and left T9 (case 2) with 5F Cobra 2 catheters (Terumo, Japan) during a 20-second rotational acquisition. Thirty milliliters of a 75% saline and 25% contrast solution (Omnipaque 300; GE) was administered. The rotational data set was reconstructed on a dedicated workstation (Leonardo; Siemens, Erlangen, Germany) through the use of regular and high-resolution matrixes, 0.4- and 0.1-mm voxel size, respectively. RESULTS: Spinal digital subtraction angiography was unremarkable in both cases. In case 1, FPCA findings indicated an atypical network of prominent posterior perimedullary veins. In case 2, FPCA identified radially oriented channels forming a caput medusae pattern collecting into an enlarged intramedullary vein. CONCLUSION: The unique ability of FPCA to image the spinal venous system enables the angiographic detection and characterization of abnormal spinal veins associated with CMs. Differentiating between the types of associated cryptic venous malformations may aid in surgical planning because the intramedullary type is associated with a higher risk of surgical complication.

Internal Mammary Arteries Supplying Hepatocellular Carcinoma: Vascular Anatomy at Digital Subtraction Angiography in 97 Patients

Radiology ◽  
2007 ◽  
Vol 242 (3) ◽  
pp. 925-932 ◽  
Author(s):  
Hyo-Cheol Kim ◽  
Jin Wook Chung ◽  
Seung Hong Choi ◽  
Hwan Jun Jae ◽  
Whal Lee ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Digital Subtraction Angiography ◽  
Vascular Anatomy ◽  
Digital Subtraction ◽  
Mammary Arteries ◽  
Internal Mammary

scholarly journals Automatic detection on intracranial aneurysm from digital subtraction angiography with cascade convolutional neural networks

2019 ◽  
Vol 18 (1) ◽  
Author(s):  
Haihan Duan ◽  
Yunzhi Huang ◽  
Lunxin Liu ◽  
Huming Dai ◽  
Liangyin Chen ◽  
...  
Keyword(s):  
Feature Extraction ◽  
Intracranial Aneurysm ◽  
Digital Subtraction Angiography ◽  
Intracranial Aneurysms ◽  
Detection System ◽  
Extraction Methods ◽  
Digital Subtraction ◽  
Two Stage ◽  
Data Set ◽  
Research Studies

Abstract Background An intracranial aneurysm is a cerebrovascular disorder that can result in various diseases. Clinically, diagnosis of an intracranial aneurysm utilizes digital subtraction angiography (DSA) modality as gold standard. The existing automatic computer-aided diagnosis (CAD) research studies with DSA modality were based on classical digital image processing (DIP) methods. However, the classical feature extraction methods were badly hampered by complex vascular distribution, and the sliding window methods were time-consuming during searching and feature extraction. Therefore, developing an accurate and efficient CAD method to detect intracranial aneurysms on DSA images is a meaningful task. Methods In this study, we proposed a two-stage convolutional neural network (CNN) architecture to automatically detect intracranial aneurysms on 2D-DSA images. In region localization stage (RLS), our detection system can locate a specific region to reduce the interference of the other regions. Then, in aneurysm detection stage (ADS), the detector could combine the information of frontal and lateral angiographic view to identify intracranial aneurysms, with a false-positive suppression algorithm. Results Our study was experimented on posterior communicating artery (PCoA) region of internal carotid artery (ICA). The data set contained 241 subjects for model training, and 40 prospectively collected subjects for testing. Compared with the classical DIP method which had an accuracy of 62.5% and an area under curve (AUC) of 0.69, the proposed architecture could achieve accuracy of 93.5% and the AUC of 0.942. In addition, the detection time cost of our method was about 0.569 s, which was one hundred times faster than the classical DIP method of 62.546 s. Conclusion The results illustrated that our proposed two-stage CNN-based architecture was more accurate and faster compared with the existing research studies of classical DIP methods. Overall, our study is a demonstration that it is feasible to assist physicians to detect intracranial aneurysm on DSA images using CNN.

scholarly journals The role of combined computed tomographic angiography and digital subtraction angiography in the management of cervico-facial vascular lesions

2021 ◽  
Vol 52 (1) ◽  
Author(s):  
Ahmed Mostafa Mohamed Kassem ◽  
Alaa Mohamed Fathy ◽  
Abdel Aziz Mohamed Alnekidy ◽  
Mohamed Ahmed Morsy ◽  
Mohamed Mahmoud El Shafei
Keyword(s):  
Success Rate ◽  
Digital Subtraction Angiography ◽  
Computed Tomographic Angiography ◽  
Vascular Lesions ◽  
Digital Subtraction ◽  
Technical Success ◽  
Technical Success Rate ◽  
Computed Tomographic ◽  
Tomographic Angiography

Abstract Background Cervicofacial vascular lesions are one of the most challenging diseases managed by intervention radiologists and specialized surgeons. These lesions were diagnosed to be vascular in origin by other imaging techniques such as Duplex and/or magnetic resonance imaging (MRI). All patients underwent computed tomographic angiography (CTA) to confirm the diagnosis as well as to decide the most effective choice of management based on multidisciplinary team (MDT). Then, Digital subtraction angiography (DSA) was done as it is offering an accurate vascular map for the vascular lesions which is inevitable for successful super-selective endovascular embolization which can be done at same sitting. Small cases of arteriovenous malformations (AVMs) were sufficiently managed by only embolization, whereas cases of adequately embolized large AVMs as well as juvenile nasopharyngeal angiofibroma (JNA) cases were followed by surgery with the advantage of less blood loss and decreasing operation time as well as complications. This prospective study was done to highlight the role of combined CTA and DSA in cervicofacial vascular lesion management. Results Twenty patients were included in our study: 16 patients were males, and 4 were females; 17 of them were under 40 years, and three were above 40 years. Preoperative embolization was done in 12 patients, which were all the cases of JNAs and large AVMs. Four patients were managed by only embolization as a definitive treatment. Complete technical success rate was about 94%, while only 6% (single case) of the partial technical success rate which was due to a very small accessory feeder that could not be catheterized even with repeated trials. Conclusions Combined CTA and DSA is the cornerstone for managing vascular lesions in the cervicofacial region, which necessitates a MDT to decide the most beneficial and least complicated way for management.

scholarly journals Neurointerventional participation in craniopagus separation

2015 ◽  
Vol 21 (4) ◽  
pp. 552-557 ◽  
Author(s):  
Riyadh Nasser Alokaili ◽  
Muhammad Ejaz Ahmed ◽  
Ahmed Al Feryan ◽  
James T Goodrich ◽  
Ahmed Aloraidi
Keyword(s):  
Digital Subtraction Angiography ◽  
Vascular System ◽  
Three Dimensional ◽  
Vascular Anatomy ◽  
Conjoined Twins ◽  
Digital Subtraction ◽  
Endovascular Techniques ◽  
Limited Experience ◽  
Scale Models ◽  
Neuroimaging Techniques

Craniopagus-type conjoined twins (joined at the head) are exceedingly rare. Separation of craniopagus conjoined twins is a challenging task mainly owing to complex vascular anatomy and limited experience with this disorder. Modern neuroimaging techniques including digital subtraction angiography can be used to preoperatively assess the cerebral vascular system. These techniques can also provide the raw data to fabricate three-dimensional true-scale models. We report a case in which endovascular techniques have been used in the separation of craniopagus conjoined twins. To our knowledge there are no reports of successful incorporation of neurointerventional methods in the disconnection of shared venous channels.

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