DIGITAL ANGIOTOMOSYNTHESIS FOR PREOPERATIVE EVALUATION OF CEREBRAL ARTERIOVENOUS-MALFORMATIONS AND GIANT ANEURYSMS

PURPOSE: To evaluate the clinical utility of the digital angiotomosynt hesis technique for giving additional information regarding critical a natomy of cerebrovascular lesions before surgical intervention. METHOD : Seven arteriovenous malformations and three giant aneurysms were exa mined with digital angiotomosynthesis; these images were compared with conventional angiograms. RESULTS: 1) Detailed recognition of three-di mensional vascular structures of the arteriovenous malformation and gi ant aneurysm was facilitated by the cine mode of digital angiograms an d angiotomograms. 2) Reconstructed angiotomograms could show clear sep aration of overlapping vessels and demonstrate fine vasculature. 3) Fi ne feeders, which were difficult to trace on the conventional angiogra m, were more easily recognized in ail cases of arteriovenous malformat ion. 4) Small arteries passing in close proximity to the arteriovenous malformation nidus were identifiable. 5) Fine arterial branches, bein g obscured by big shadows of giant aneurysms on the conventional angio grams, were well identified. 6) The anatomic relationship of bone stru ctures to the giant aneurysm was clearly shown. CONCLUSIONS: Digital a ngiotomosynthesis is helpful for recognizing the three-dimensional and detailed vascular anatomy of arteriovenous malformations and giant an eurysms and provides neurosurgeons with useful information for preoper ative evaluation.