ROTATIONAL ANGIOGRAPHY ASSESSMENT OF CEREBRAL ANEURYSMS

PURPOSE: To compare rotational angiography with conventional digital s ubtraction angiography in the assessment of cerebral aneurysms. METHOD S: Conventional digital subtraction angiography and rotational angiogr aphy were compared in 57 patients investigated for the preoperative di agnosis of subarachnoid hemorrhage and in 13 patients after surgery. I mages were compared for location, visibility of the aneurysmal neck, v ascular branch anatomy, projection, size, presence of spasm, and shape of the aneurysm. RESULTS: Rotational angiography was superior to the digital angiogram in assessing aneurysms and vascular anatomy in the f ollowing percentage of cases: 12% for location, 46% for the presence o f a neck, 32% in the assessment of branch anatomy, 19% for projection, 12% for size, 3.5% for spasm, and 19% for shape. After surgery, rotat ional angiography more clearly demonstrated the presence or absence of a neck in 69% of the cases. CONCLUSIONS: Relational angiography often allows better visualization of vascular anatomy and therefore improve s the angiographic assessment of aneurysms when compared with conventi onal digital subtraction angiography, making it an excellent adjunct i n the investigation of subarachnoid hemorrhage. The lack of subtractio n artifacts from the surgical clips and multiple angles of view also a llow better assessment of the presence or absence of a residual neck i n postoperative cases.