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

Dobrocky, Tomas; Matzinger, Marco; Piechowiak, Eike I; Kaesmacher, Johannes; Pilgram-Pastor, Sara; Goldberg, Johannes; Bervini, David; Klail, Tomas; Pereira, Vitor Mendes; Z'Graggen, Werner; Raabe, Andreas; Mordasini, Pasquale; Gralla, Jan (2023). Benefit of Advanced 3D DSA and MRI/CT Fusion in Neurovascular Pathology. Clinical neuroradiology, 33(3), pp. 669-676. Springer-Verlag 10.1007/s00062-022-01260-0

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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.

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