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Comparison of 2D and 3D Digital Subtraction Angiography in Evaluation of Intracranial Aneurysms

Takeshi Sugaharaa, Yukunori Korogib, Kouji Nakashimaa, Satoshi Hamatakea, Shin Hondaa and Mutsumasa Takahashib

a Departments of Radiology, Health and Welfare Hospital, Kumamoto, Japan
b the Kumamoto University School of Medicine, Kumamoto, Japan



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  		FIG 1. Images from the case of a 64-year-old female patient with multiple aneurysms.

A, Anteroposterior standard 2D DSA shows right anterior (arrow) and posterior communicating (double arrows) artery aneurysms, but the right middle cerebral artery aneurysm cannot be visualized (arrowhead).

B, Lateral standard 2D DSA shows right anterior (arrow) and posterior communicating (double arrows) artery aneurysms, but the right middle cerebral artery aneurysm cannot be visualized (arrowhead).

C, Rotational DSA image, which can be seen stereoscopically, clearly shows the relationship of the right anterior (arrow) and posterior communicating (double arrows) artery aneurysms to the neighboring vessels and to the aneurysmal necks. The right middle cerebral artery aneurysm (arrowhead) can be seen, but the relationship to the neighboring vessels and the aneurysmal neck are obscured by the superimposition of the surrounding arteries. Note that minimal misregistrations are observed.

D, MIP image clearly shows the relationship of the right anterior (arrow) and posterior communicating (double arrows) artery aneurysms to the neighboring vessels and to the aneurysmal necks. The right middle cerebral artery aneurysm (arrowhead) can be seen, but the relationship to the neighboring vessels and the aneurysmal neck are obscured by the superimposition of the surrounding arteries. Minimal misregistrations do not create artifacts.

E, SSD image clearly shows the relationship of the right anterior (arrow) and posterior communicating (double arrows) artery aneurysms to the neighboring vessels and to the aneurysmal necks. The right middle cerebral artery aneurysm (arrowhead) is seen, and the relationship to the neighboring vessels and aneurysmal neck are easily recognized. Minimal misregistrations do not create artifacts.



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  		FIG 2. Images from the case of a 67-year-old female patient with a right middle cerebral artery aneurysm.

A, Anteroposterior standard 2D DSA image. The aneurysm can be identified (arrow), but the identification of the presence of aneurysmal lobulation and the relationship to neighboring arteries is difficult.

B, Lateral standard 2D DSA image. The aneurysm can be identified (arrow), but the presence of aneurysmal lobulation and the relationship to neighboring arteries is difficult to discern.

C, Rotational DSA image, which can be seen stereoscopically, clearly shows the aneurysm (arrow), but the superimposition of many neighboring arteries makes it difficult to evaluate the presence of aneurysmal lobulation and the relationship to neighboring arteries.

D, MIP image clearly shows the aneurysmal lobulation and relationship to neighboring arteries (arrow).

E, SSD image is especially clear in showing the aneurysmal lobulation and relationship to neighboring arteries.



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  		FIG 3. Images from the case of a 61-year-old male patient with a left anterior communicating artery aneurysm.

A, Lateral standard 2D DSA image. Few image artifacts are noted.

B, Rotational DSA image. Image artifacts are severe.

C, MIP image. Image artifacts create blurring (arrowheads).

D, SSD image. Image artifacts create abnormal irregular structures (arrowheads).





Copyright © 2009 by the American Society of Neuroradiology. Print ISSN: 0195-6108 Online ISSN: 1936-959X