ANALYSIS OF CEREBROVASCULAR DISEASES BY A NEW 3-DIMENSIONAL COMPUTERIZED X-RAY ANGIOGRAPHY SYSTEM

We set out to validate the concept of three-dimensional (3D) angiograp hy. We evaluated the sensitivity and the quality of morphological anal ysis mode possible by an experimental system for imaging cerebrovascul ar disease versus standard digital subtraction angiography (DSA). The system, the 3D Morphometer, is a computerised X-ray angiography unit c apable of acquiring a set of two-dimensional (2D) projections during a rotation and then reconstructing a 3D volume from them. We studied 78 patients with suspected cerebrovascular disease. 3D and 2D images (st andard 2D DSA performed during the same procedure), were reviewed blin dly to assess detection and display of morphological characteristics o f cerebrovascular diseases. We found 53 aneurysms, 22 arteriovenous ma lformations and two venous angiomas. On 3D angiography we detected two aneurysms we missed on 2D angiography. In 47 aneurysms on which furth er data were obtained during surgery or embolisation, the 3D angiograp hy allowed more accurate analysis of the neck and surrounding vessels in cases in which the 2D angiographic findings were doubtful. Assessme nt of arteriovenous malformations was equivalent with both techniques. Under the conditions of our study, the technical constraints being th e same for both methods, 3D angiography was superior to 2D angiography . Implementation on Carm vascular systems is being evaluated.