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FIG 2. Left distal anterior cerebral artery aneurysm in a 69-year-old man.
A, Anteroposterior and B, lateral 2D DSA images of the left internal carotid artery depict a 19-mm aneurysm at the distal anterior cerebral artery. However, the relationship between the aneurysm and the adjacent arteries is not clearly demonstrated on this 2D DSA image and the rotational DA image (not shown). Regarding the relationship on rotational DA image, two observers ranked it as ambiguous visualization.
C–E, Three-dimensional DA images from behind depict a distal anterior cerebral aneurysm. MIP 3D image (C) does not demonstrate the relationship between the aneurysm and the two adjacent arteries (arrowheads) deriving from the aneurysm because of superimposition of the aneurysm and the arteries; the two observers classified this aneurysm as insufficient visualization on delineation of shape and relationship. The SSD (D) and volume-rendering (E) 3D images clearly show the shape and relationship (arrowheads), which were ranked as sufficient visualization by the two observers. Neurosurgeons chose to performed surgery on the basis of this additional information, and the relationship was confirmed during surgery.
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