PT  - JOURNAL ARTICLE
AU  - J. Chen
AU  - T. Ethiati
AU  - P. Gailloud
TI  - Flat Panel Catheter Angiotomography of the Spinal Venous System: An Enhanced Venous Phase for Spinal Digital Subtraction Angiography
AID  - 10.3174/ajnr.A3111
DP  - 2012 Nov 01
TA  - American Journal of Neuroradiology
PG  - 1875--1881
VI  - 33
IP  - 10
4099  - http://www.ajnr.org/content/33/10/1875.short
4100  - http://www.ajnr.org/content/33/10/1875.full
SO  - Am. J. Neuroradiol.2012 Nov 01; 33
AB  - BACKGROUND AND PURPOSE: While spinal DSA remains the reference standard technique for spinovascular imaging, visualizing spinal veins remains challenging due to their small size and motion artifacts. This study evaluates the ability of FPCA to overcome these obstacles. MATERIALS AND METHODS: Sixty-three FPCAs, performed by intersegmental artery injections in 57 patients, were prospectively evaluated. Entrance skin doses were compared with standard spinal DSA runs, including a venous phase and cerebral FPCAs. FPCA contributions were stratified as 1) provided no added information, 2) complemented spinal DSA findings, 3) assisted therapy planning, and 4) contributed principal diagnostic findings. RESULTS: No complications were observed. Diagnoses included vascular malformations (44%), stroke (9%), venous anomalies (10%), other (9%), and unremarkable (28%). Mean entrance skin doses were of 419 mGy for FPCA, 161 mGy for spinal DSA with venous phase, and 309 mGy for cerebral FPCAs. FPCA contributed the principal diagnostic finding in 16 cases (25.4%), assisted therapy planning in 13 cases (20.6%), complemented spinal DSA findings in 12 cases (19.1%), and provided no additional information in 20 cases (31.7%). In 8 of these 20 cases, FPCA documented a spinal venous anatomy that was poorly visualized or not visualized on spinal DSA. CONCLUSIONS: Spinal FPCA is safe, with a moderate increase in radiation dose, compared with spinal DSA with venous phase or cerebral FPCA. It proved particularly valuable for therapy planning and the diagnosis of venous abnormalities. This study suggests that FPCA has an important role to play in the evaluation of the spinal venous system. FPCAflat panel catheter angiotomographyMIPmaximum intensity projection