Sandoval-Garcia C, Royalty K, Aagaard-Kienitz B, Schafer S, Yang P, Strother C
From the Departments of Neurological Surgery (C.S.-G., B.A.-K.).
Biomedical Engineering (K.R) Siemens (K.R., S.S.), Hoffman Estates, Illinois.
AJNR Am J Neuroradiol. 2015 Oct;36(10):1959-63. doi: 10.3174/ajnr.A4359. Epub 2015 Jun 18.
4D DSA allows viewing of 3D DSA as a series of time-resolved volumes of a contrast bolus. There is no comparison of the accuracy of the anatomic information provided by 4D DSA with that available from conventional 2D and 3D DSA. Our purpose was to make this comparison by using a canine model.
2D, 3D, and 4D DSA acquisitions were performed in 5 canines from 3 catheter positions in the common carotid artery yielding 15 2D, 15 3D, and 15 4D datasets. For each territory, 3 vascular segments were chosen for comparison. Images were reviewed by 2 experienced neuroradiologists and were graded by the ability to visualize a segment, its filling direction, and preferred technique. Two visualization modes for 4D DSA were compared (volume-rendering technique and MIP).
4D DSA was preferred in 73.9% of the image sets; 2D, in 22.7%; and 3D, in 3.4%. 4D DSA MIP rendering yielded superior visualization of very small vessel details; the 4D DSA volume-rendering technique offered superior depth and overlap information and better visualization of the surface details of the vasculature.
In this study, 4D DSA was preferred over 2D and 3D DSA for analysis of normal vasculature. The ability to provide any view of a vascular territory at any time during passage of a contrast bolus seems likely to reduce the need for many 2D acquisitions during diagnostic and therapeutic procedures. This then potentially translates into a reduction in radiation and contrast dose.
4D DSA能够将3D DSA视为一系列造影剂团注的时间分辨容积。目前尚无对4D DSA所提供的解剖学信息准确性与传统2D和3D DSA所提供信息准确性的比较。我们的目的是利用犬类模型进行此项比较。
在5只犬的颈总动脉3个导管位置进行2D、3D和4D DSA采集,共产生15个2D、15个3D和15个4D数据集。对于每个区域,选择3个血管节段进行比较。由2名经验丰富的神经放射科医生对图像进行评估,并根据显示节段的能力、其充盈方向和首选技术进行分级。比较了4D DSA的两种可视化模式(容积再现技术和最大密度投影)。
在73.9%的图像集中,4D DSA是首选;2D为22.7%;3D为3.4%。4D DSA最大密度投影对非常小的血管细节显示更佳;4D DSA容积再现技术提供了更好的深度和重叠信息,以及对脉管系统表面细节的更好显示。
在本研究中,对于正常脉管系统分析,4D DSA优于2D和3D DSA。在造影剂团注通过期间的任何时间提供血管区域任何视图的能力,似乎有可能减少诊断和治疗过程中许多2D采集的需求。这进而可能转化为辐射和造影剂剂量的减少。