DOCSLIB.ORG

Digital Subtraction Cerebral Angiography by Intraarterial Injection: Comparison with Conventional Angiography

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Digital Subtraction Cerebral Angiography by Intraarterial Injection: Comparison with Conventional Angiography 593 Digital Subtraction Cerebral Angiography by Intraarterial Injection: Comparison with Conventional Angiography Michael Brant-Zawadzki1 , 2 For 4 months, a prototype digital subtraction system was used to obtain images of Robert Gould2 the cerebral vasculature after intraarterial contrast injections. In 12 instances, the David Norman2 intraarterial injections were recorded with both a digital subtraction unit and conven­ Thomas H. Newton2 tional direct magnification film-screen system. The digital subtraction and conventional Barton Lane3 film subtraction images were compared and graded for quality and information content by three skilled observers. In addition, quantitative measurements of contrast-detail performance and spatial resolution were obtained on both the digital system and the screen-film imaging chain. In a clinical setting, both the digital subtraction and conven­ tional film-screen systems provided similar quality images and angiographic informa­ tion. Contrast-detail curves demonstrated that digital subtraction angiography outper­ formed conventional film technique for low-contrast objects. Digital subtraction an­ giography also reduced the time required to obtain the angiogram, markedly reduced film cost, and lowered the contrast agent burden. Digital subtraction imaging of the extra- and intracranial cerebral vasculature after intravenous injections of contrast materi al is becoming an established screening procedure [1-3]. Patient motion, superimposition of multiple vessels, contrast agent burden, and suboptimal resolution [4] restrict the diagnostic utility of this method. Early work has suggested, however, that digital subtraction imaging of intraarteri al contrast injections can provide images of sufficient diagnostic quality to obviate conventional film-screen angiography, thus reducing film cost, and possibly decreasing time required for the examination [5, 6]. For 4 months, we have evaluated intraarterial cerebral digital subtraction angiography (DSA). In selected instances, a comparison of digital and film-screen angiography was made in the same patient. In addition, quantitative measurements of spatial resolution and contrast sensitivity were obtained for both the digital and film­ This article appears in the November / Decem­ screen systems. ber 1982 issue of AJNR and the February 1983 issue of AJR. Received April 27. 1982; accepted after revi­ sion July 9. 1982. Subjects and Methods Presented at the XII Symposium Neuroradiolo­ gicum, Washington, D.C., October 1982. Equipment 1 Departm ent of Radiology, San Francisco Gen­ The OSA unit (OF 100, Oi asonics, Inc.) was a prototype, the essential components of eral Hospital, 1001 Potrero Ave., San Francisco, which included a progressively scanned video camera with a 1000:1 signal-to-noise rati o, CA 9411 O. Address reprint requests to M. Brant Zawadzki. interfaced with a 9-inch- (22.9 cm) diameter, triple-mode, cesium iod ide image intensifier (Fluoricon 300, G.E. Medical Systems). Exposures were pulsed using a 0 .6 mm focal spot 2 Department of Radiology, University of Cali­ fornia Medical Center, San Francisco, CA 94143. x-ray tube (Maxi 100, G.E. Medical Systems). Typical exposure fac tors were 70-85 kVp, 600 rnA , 0.01 3-0.030 sec. Mask mode subtraction images were recorded on a multiformat 3 Department of Radiology, Mt. Zion Hospital, San Francisco, CA 94 120. camera (Matrix In struments). Conventional 1 .8-2 x magnification arteriograms were obtained with Quanta III screens AJNR 3:593-599, November/ December 1982 0195-6108/ 82/0306- 0593 $00.00 and Cronex 4 film (duPont, Inc. ), using a 0.16 mm or 0 .2 mm biased focal spot tube (Maxi © American Roentgen Ray Society 125, G.E. Medical Systems). 594 BRANT-ZAWADZKI ET AL. AJNR :3, November/ December 1982 Clinical Studies systems. A Lucite ph antom was used to analyze the trade-off between spatial resolution and contrast sensitivity. Holes of pro­ Twenty-two pati ents were studied after conve ntional percuta­ gressively smaller diameter and depth were drilled through a 2 .54- neous selective catheterization of th e carotid and/or vertebral cm-thick Lucite block, the sm all est holes measuring 0.5 mm (fig. arteries. The patients were 14-82 years old and exhibited a broad 1). Measurements of x-ray intensity transmitted through the solid spectrum of pathology (table 1). A total of 50 angiographic seri alo­ block of Lucite and through different thicknesses of Lu cite corre­ grams were obtained usin g a mask mode digital subtraction tech­ sponding to that thickness remaining after the holes were drilled nique. In 12 instances, images were also recorded on the conven­ were made using a calibrated ionization chamber (MOH model tional film-screen system. Contrast injecti on rates for th e conven­ tional angiog rams were standard (8 ml volume, 5 ml /sec rate in the internal carotid artery; 10 ml volume, 8 ml /sec rate in the common 100 carotid artery; 9 ml volume, 6 ml /sec rate in th e vertebral artery). 80 When the patients were studied with DSA, the contrast volume used was typically 60%-80% that of the conventional arteri ographic 50 study. The rate of injecti on was also decreased by a similar factor. Conventional film subtracti ons of selected key images were ob­ 30 tained. We then matched the digital and conventional subtraction 20 digital images, and three of the coauthors evaluated the matched pairs, unsubtracted III! grading them on a 1 -3 scale (1 = inadequate; 2 = adequate; 3 = Cii excell ent). Three separate categories of informati on were evalu­ ~ 10 C ated: large vessel (>1 mm) resolution, small vessel «1 mm) reso­ 0 8 lution (e.g., anterior choroidal, lenticulostriate, etc. ), and image u contrast within the vessels. The points awarded in each category 5 were then summed for both the digital and the conventional film 3 angiograms and compared. In addition, a judgment was passed on each study as to its overall diagnostic quality. 2 Quantitative Measurements 1 0.1 .2 .3 .5 .7 2 3 5 7 10 A conventional lead-bar test pattern was used for measurements Hole diameter, mm of the spatial resolution of both th e digital and screen-film imaging Fig. 2. - Contrast-detail curves for conventional film-screen and OSA im ages obtained by plotting smallest diameter hole visible at any given contrast level (see tex t). Imag ing system performance improves as curve is closer to orig in , since a smaller-sized obj ect can be visualized at a given TABLE 1: Clinical and/ or Radiologic Diagnosis in Patients object contrast level. St udied with DSA Pathotogy No. Patients Tumor 4 TABLE 2: Comparison of DSA and Conventional Angiography Carotid atherosclerosis 3 Vertebrobasilar occlusion ........... .. 3 Totat Score' Tra uma 3 OSA Conventional Aneurysm/ subarachnoid bleed 3 Intraventricular bleed 1 Large vessel resolution 99 100 Crypti c arteriovenous malformation 2 Small vessel resolution 75 83 Spontaneous cavern ous/ carotid fi stula 1 Contrast density 102 95 Other .... ... .. .. 2 Diagnostic study? All All - - ---- Total 22 • Totaled fo r 12 studies by three observers in each category. Scores: 1 = suboptimal; 2 = good: 3 = excellent. Fig. 1.- Contrast-detail phantom. A, Ori ginal film-screen image of Lucite phantom (mag ni fica ti on X l .8) with holes of varying diameter drilled to progres­ sively shallower depths from left to ri gh t. B, Conventional fil m subtraction shows inc rease of random (q uantu m) noise on image of phantom . A B AJNR:3, November/ December 1982 CEREBRAL DIGITAL SUBTRACTION ANGIOGRAPHY 595 A B c o Fig . 3.- Spontaneous dural arteriovenous communication in 42-year-old compared with conventional subtraction, accounting for slight diHerences in woman with right exophthalmos. Left internal carotid angiography. A, Se­ number of vessels filled. C, Conventional subtraction angiogram, magnifica­ lected conventional subtraction of angiogram, AP view (magnification X l .8). tion x 2, in lateral projection. D, DSA, in the lateral projection (reversed Abnormal arteriovenous communication with filling of contralateral (right) polarity). Abnormal dural communication in posterosuperiqr cavernous sinus cavernous sinus and superior ophthalmic vein. e, Matched digital subtraction, region, with retrograde filling of right superior ophthalmic vein and basilar AP view. Comparable detail of anterior choroidal artery, ophthalmic artery, venous plexus. and larger vessels. Digital subtraction was obtained earlier in flow sequence 1015). The subject contrast for each hole depth was defined as a Results percentage difference in measured x-ray intensity transmitted through the original Lucite block as compared with that transmitted Our clinical data summarized in table 2 show that both through the thickness of Lucite remaining after the hole was drill ed. techniques provided eq uivalent large-vessel resolution (> 1 For these measurements, the ionization chamber was placed in the image plane and the x-ray field size was not changed. The diameter mm). Vessels less than 200 ILm in diameter were not as well of the smallest hole visible at each particular depth (contrast) was resolved on the DSA images, as would be predicted from then plotted on a graph (fig. 2). Separate curves were obtained for both the theoretical and measured limits of spati al resolution non subtracted and subtracted digital images and non subtracted of the two systems. Overall image contrast was superior in and subtracted film images. the DSA images despite the lower contrast volume and 596 BRANT-ZAWADZKI ET AL. AJNR:3, November/ December 1982 A 8 Fig . 4.-Encasement of callosomargin al artery due to metastasis to falx in terior cerebral artery at rostrum of corpus call osum . B, DSA (later phase in 60-year-old woman with lung carcinoma. A, Conventional subtraction arterio­ flow seq uence). En casement of callosomarginal and in cidental narrowing of gram, magnification x 2 (right internal carotid artery injection). Encasement anterior cerebral artery. Comparable small vessel detail. of callosomargin al artery. Incidentall y, mild atherosclerotic narrowing in an- 8 Fig. 5.-Atherosclerosis of precavernous and cavernous segment, right image from DSA study several days later.
Load more

Recommended publications
  • Neuroradiology Back to the Future: Brain Imaging
    Published December 8, 2011 as 10.3174/ajnr.A2936 50TH ANNIVERSARY PERSPECTIVES Neuroradiology Back to the Future: Brain Imaging E.G. Hoeffner SUMMARY: The beginning of neuroradiology can be traced to the early 1900s with the use of skull S.K. Mukherji radiographs. Ventriculography and pneumoencephalography were introduced in 1918 and 1919, re- spectively, and carotid angiography, in 1927. Technical advances were made in these procedures A. Srinivasan during the next 40 years that lead to improved diagnosis of intracranial pathology. Yet, they remained D.J. Quint invasive procedures that were often uncomfortable and associated with significant morbidity. The introduction of CT in 1971 revolutionized neuroradiology. Ventriculography and pneumoencephalogra- phy were rendered obsolete. The imaging revolution continued with the advent of MR imaging in the early 1980s. Noninvasive angiographic techniques have curtailed the use of conventional angiography, and physiologic imaging gives us a window into the function of the brain. In this historical review, we will trace the origin and evolution of the advances that have led to the quicker, less invasive diagnosis and resulted in more rapid therapy and improved outcomes. ABBREVIATIONS: CPA ϭ cerebellopontine angle; EDH ϭ epidural hematoma; LP ϭ lumbar punc- ture; NMR ϭ nuclear magnetic resonance; SDH ϭ subdural hematoma fforts to image the CNS began with skull radiographs duced by trauma, surgery, or infection.3 Skull radiographs Eshortly after Roentgen’s discovery of x-rays.1-3 In the early were also used to diagnose fractures and foreign bodies.9 20th century, contrast studies of the brain, by using air for Obtaining a single skull radiograph took minutes, with the contrast, were developed with the introduction of ventriculog- radiograph being produced on a glass plate with a slowly re- raphy and pneumoencephalography.4,5 Shortly thereafter, ce- sponding photographic emulsion.
    [Show full text]
  • Clinical Utility of Arterial Spin-Labeling As a Confirmatory
    CLINICAL REPORT BRAIN Clinical Utility of Arterial Spin-Labeling as a Confirmatory Test for Suspected Brain Death K.M. Kang, T.J. Yun, B.-W. Yoon, B.S. Jeon, S.H. Choi, J.-h. Kim, J.E. Kim, C.-H. Sohn, and M.H. Han ABSTRACT SUMMARY: Diagnosis of brain death is made on the basis of 3 essential findings: coma, absence of brain stem reflexes, and apnea. Although confirmatory tests are not mandatory in most situations, additional testing may be necessary to declare brain death in patients in whom results of specific components of clinical testing cannot be reliably evaluated. Recently, arterial spin-labeling has been incorpo- rated as part of MR imaging to evaluate cerebral perfusion. Advantages of arterial spin-labeling include being completely noninvasive and providing information about absolute CBF. We retrospectively reviewed arterial spin-labeling findings according to the following modified criteria based on previously established confirmatory tests to determine brain death: 1) extremely decreased perfusion in the whole brain, 2) bright vessel signal intensity around the entry of the carotid artery to the skull, 3) patent external carotid circulation, and 4) “hollow skull sign” in a series of 5 patients. Arterial spin-labeling findings satisfied the criteria for brain death in all patients. Arterial spin-labeling imaging has the potential to be a completely noninvasive confirmatory test to provide additional information to assist in the diagnosis of brain death. ABBREVIATION: ASL ϭ arterial spin-labeling rain death is defined as irreversible loss of brain and brain bioelectrical activity, electroencephalography is used in many Bstem function.
    [Show full text]
  • Neurosonology: Transcranial Doppler
    1 Neurosonology: Transcranial Doppler Mark N. Rubin, M.D. Vascular & Hospital Neurology, Neurosonology Assistant Professor of Neurology Email: [email protected] Google Scholar _______________________________ Northwest Neurology https://www.northwestneuro.com/ 2 Contents Transcranial Doppler (TCD) Services and Indications ........................................................................ 3 What is TCD? ............................................................................................................................... 3 What can be accomplished with TCD? .......................................................................................... 3 When is TCD useful? .................................................................................................................... 3 Overview of TCD Ultrasonography ................................................................................................... 4 General Principles of TCD ............................................................................................................. 4 TCD Technique ............................................................................................................................. 7 Patient Safety .............................................................................................................................. 7 Evidence Compendium by Indication ............................................................................................... 8 Cerebrovascular Disease .............................................................................................................
    [Show full text]
  • Cerebral Angiography
    Cerebral Angiography Cerebral angiography uses a catheter, x-ray imaging guidance and an injection of contrast material to examine blood vessels in the brain for abnormalities such as aneurysms and disease such as atherosclerosis (plaque). The use of a catheter makes it possible to combine diagnosis and treatment in a single procedure. Cerebral angiography produces very detailed, clear and accurate pictures of blood vessels in the brain and may eliminate the need for surgery. Your doctor will instruct you on how to prepare, including any changes to your medication schedule. Tell your doctor if there's a possibility you are pregnant and discuss any recent illnesses, medical conditions, medications you're taking, and allergies, especially to iodinated contrast materials. If you're breastfeeding, ask your doctor how to proceed. If you are to be sedated, you may be told not to eat or drink anything for four to eight hours before your procedure. Also, you should plan to have someone drive you home. Leave jewelry at home and wear loose, comfortable clothing. You will be asked to wear a gown. What is Cerebral Angiography Angiography is a minimally invasive medical test that uses x-rays and an iodine-containing contrast material to produce pictures of blood vessels in the brain. In cerebral angiography, a thin plastic tube called a catheter is inserted into an artery in the leg or arm through a small incision in the skin. Using x-ray guidance, the catheter is navigated to the area being examined. Once there, contrast material is injected through the tube and images are captured using ionizing radiation (x-rays).
    [Show full text]
  • 2018 PTOS Manual
    2018 PENNSYLVANIA TRAUMA SYSTEMS FOUNDATION OPERATIONAL MANUAL FOR THE DATA BASE COLLECTION SYSTEM 1 TABLE OF CONTENTS TOPIC PAGE NUMBER PREFACE .................................................................................................................................................. 10 GENERAL INSTRUCTIONS ........................................................................................................................ 12 PTOS PATIENT INCLUSION CRITERIA ....................................................................................................... 14 SECTION I: DEMOGRAPHIC DATA .......................................................................................................... 18 INSTITUTION NUMBER .............................................................................................................. 19 ZIP CODE OF RESIDENCE ........................................................................................................... 19 RACE .......................................................................................................................................... 19 ETHNICITY ................................................................................................................................. 20 SEX ............................................................................................................................................. 20 DATE OF BIRTH .......................................................................................................................... 20
    [Show full text]
  • Cerebral Angiography
    Patient information factsheet Cerebral angiography Angiography is a type of x-ray test used to produce pictures of blood vessels. These pictures are known as angiograms. A cerebral angiogram shows the blood vessels in your head and neck. This factsheet explains what the procedure involves and how to prepare. Preparing for the test We may ask you to attend a clinic appointment before the procedure so that we can discuss it with you. You’ll have a blood test and we will ask you to sign a consent form. • If you have any allergies, please inform the ward staff. • If you are female and are pregnant, trying to get pregnant, or there is a chance that you are pregnant please inform us by calling the telephone number at the end of this factsheet before your admission. On the day of your appointment You may have a light breakfast (such as tea or coffee and toast), early on the morning of your appointment. You can drink clear fluids up until the time of your procedure. Please bring a dressing gown and slippers with you to the hospital. When you arrive on the ward we will ask you to change into a hospital gown and remove your underwear. You should use the toilet before the procedure as it will take at least one hour. We advise you not to use public transport after you’ve had an angiogram in case you feel unwell, so it’s important that you make arrangements for someone to collect you from the ward and take you home by car.
    [Show full text]
  • Two-Dimensional Echoencephalography with Electronic Sector Scanning Clinical Experiences with a New Method
    Journal ofNeurology, Neurosurgery, and Psychiatry, 1972, 35, 912-918 J Neurol Neurosurg Psychiatry: first published as 10.1136/jnnp.35.6.912 on 1 December 1972. Downloaded from Two-dimensional echoencephalography with electronic sector scanning Clinical experiences with a new method H. A. C. KAMPHUISEN, J. C. SOMER, AND W. A. OOSTERBAAN Department of Clinical Neurophysiology, University of Utrecht, and the Institute of Medical Physics T.N.O., Utrecht, The Netherlands SUMMARY A new form of ultrasound diagnostic possibility is presented (the electroscan). The basic principles of this two dimensional method are described. Special attention is given to the probe consisting of an array of 21 elements of piezo-electric material. The results of this method in four patients are discussed (meningioma, arteriovenous aneurysm, subdural haematoma, and a baby with hydrocephalus). The baby with hydrocephalus showed diagnostic problems which could be under- stood from the pneumoencephalographic findings. The electroscan method seems to offer good possibilities for the diagnosis of brain lesions, ifthese have a consistency different from that of normal brain tissue. guest. Protected by copyright. Conventional echoencephalography is based on difficulty from an echo answering from a real the pulse-echo method, in which a transducer layer, as would be possible in a two-dimensional transmits short ultrasound pulses, the echoes of scanning system. which are received back during the intervals. These echoes are visualized as vertical excursions on an oscilloscope-screen, while the position on ELECTRONIC SCANNING PRINCIPLE the screen is a measure for the distance at which (Somer, 1968) the reflecting structure is situated. The direction Two-dimensional scanning for obtaining cross- of the emitted ultrasound pulses is always per- sectional pictures can be performed both mech- pendicular to the surface of the probe and thus it anically and electronically.
    [Show full text]
  • A Comparison of Lopamidol and Lohexol in Cerebral Angiography
    1163 A Comparison of lopamidol and lohexol in Cerebral Angiography David M. Pelz' lopamidol and iohexol, the new nonionic low-osmolality contrast agents, have both Allan J. Fox' been shown to be safe, effective, and better tolerated than conventional ionic agents Fernando Vinuela ' .2 for cerebral angiography. In this randomized, double-blind study involving 40 patients, Pedro Lylyk '.2 these two agents were compared for adverse effects, radiographic quality, and patient tolerance. No significant differences were observed in 220 injections. Because we found iopamidol and iohexol to be equally safe and effective for cerebral angiography, the choice of which contrast agent to use should be based on other considerations. lopamidol and iohexol are two new nonionic, low-osmolality contrast agents that recently were approved for intravascular and intrathecal use in North America. Extensive research in Europe and North America has established the safety and efficacy of both agents [1, 2] compared with ionic contrast media. They have been shown to cause fewer adverse effects and less patient discomfort than ionic agents in cerebral angiography [3, 4]. No studies have directly compared these two agents in angiography, and our randomized, double-blind study was designed to compare and evaluate the patient tolerance, incidence of adverse reactions, and radiographic quality produced by iopamidol and iohexol in cerebral angiography. Subjects and Methods Forty patients undergoing routine cerebral angiography at our institution were admitted to the study. The patients were all 18 years old or older except for one who was 14 years old . Reasons for exclusion from the study included pregnancy, bleeding disorders, significant renal or hepatic dysfunction, abnormal fluid and electrolyte balance, severe debilitation, known hypersensitivity to contrast material, or prior administration of intravascular or cholangio­ graphic contrast material within 3 days of the procedure.
    [Show full text]
  • 2013 MTQIP Data Dictionary
    2013 DATA DICTIONARY Contents TRAUMA REGISTRY INCLUSION CRITERIA ............................................................................................... 1 CASE NUMBER ................................................................................................................................................... 1 TRAUMA CENTER .............................................................................................................................................. 2 DEMOGRAPHIC INFORMATION ..................................................................................................................... 2 AGE ........................................................................................................................................................................ 2 RACE ..................................................................................................................................................................... 2 SEX......................................................................................................................................................................... 3 PRE-HOSPITAL INFORMATION ...................................................................................................................... 3 INTER-FACILITY TRANSFER ........................................................................................................................... 3 INJURY INFORMATION ....................................................................................................................................
    [Show full text]
  • Stereoscopic Digital Subtraction Angiography in Neuroradiologic Assessment
    802 Stereoscopic Digital Subtraction Angiography in Neuroradiologic Assessment C. Worthington' Digital subtraction angiography (DSA) with stereoscopic imaging was performed in T. M. Peters 40 patients for evaluation of a variety of cerebrospinal disorders_ It was facilitated by a R. Ethier C-arm mounted x-ray tube and imaging chain with 7° angulation between image pairs_ D. Melanson Stereoscopic digital imaging proved particularly useful in the preoperative assessment of aneurysms, arteriovenous malformations, and primary and metastatic tumors. The J. Theron technique was also found to be useful as a real-time adjunct to therapeutic radiographic J.-G. Villemure procedures, as an aid in stereotaxic procedures, and in follow-up of postsurgical A. Olivier patients. Although the intravenous route was occasionally used, especially in postop­ J. Clark erative follow-up of aneurysms, the procedure was most often carried out via an G. Mawko intraarterial approach. Stereoscopy was useful in supplying depth information regarding the relations between lesions and surrounding normal and abnormal vasculature. This technique combines the demonstrated advantages of intraarterial DSA with the unique advantage of stereoscopic imaging to demonstrate three-dimensional detail, thus con­ tributing significantly to diagnostic confidence. Disadvantages are discussed. Further refinements in the equipment are expected: generation of stereo images with one injection, thus increasing procedure efficiency and patient safety; a video stereoscopic viewing unit; and the ability to obtain precise measurements via computer of depth, position, distance between, and true size of objects. Digital subtraction angiography (DSA) was initially conceived as a technique to study extracranial carotid occlusive disease by an intravenous approach, frequently in outpatients [1-3].
    [Show full text]
  • Dear Patient and Family
    The Johns Hopkins Hospital, Division of Interventional Neuroradiology Dear patient and family, Welcome to Johns Hopkins Medicine! Your doctor has referred you to Johns Hopkins Pediatric Interventional Neuroradiology so that we may examine or treat the blood vessels supplying your child’s head and neck. During your stay, your child will be under the care of a dedicated team of experienced healthcare professionals. Our goal is to make you as comfortable as possible during your visit to the Johns Hopkins Hospital. We hope that you will find this pamphlet useful and informative. Please read it carefully and share with us your questions and suggestions. Sincerely, Dr. Philippe Gailloud, Director Division of Interventional Neuroradiology The Johns Hopkins Hospital Email: [email protected] What is a diagnostic cerebral angiogram? A diagnostic cerebral angiogram is a medical procedure that offers an extremely precise evaluation of your child’s blood vessels. Cerebral angiography helps to diagnose medical conditions that involve the arteries and veins in the head and neck, including the brain. During a cerebral angiogram, highly specialized doctors (called neuro-angiographers) are able to examine the blood vessels by using modern sophisticated imaging equipment. In order to take pictures of the blood vessels, a contrast medium, or “dye,” is given through a small, soft, and flexible tube called a catheter. This catheter is inserted in the groin and carefully advanced towards the targeted blood vessel under the guidance of low dose x-rays. Images of the blood vessels are then obtained by injecting the contrast medium through the catheter into the blood vessel, and by taking x-ray pictures as the contrast agent travels through the arteries and veins (Figure 1).
    [Show full text]
  • Tohoku J. Exp. Med., 1970, 102, 13-21 Cerebral Angiography And
    Tohoku J. exp. Med., 1970, 102, 13-21 Cerebral Angiography and Electroencephalography in Cerebrovascular Disease NOBCUo YosHrr Division of Neurological Surgery Department of Surgery, Keio University School of Medicine, Tokyo YosEm, N. Cerebral Angiography and Electroencephalography in Cerebrovas cular Disease. Tohoku J. exp. Med., 1970, 102(1), 13-21•\The continuous EEG recording was performed on 48 patients with cerebrovascular diseases before, during and after the injection of the contrast medium into the common carotid artery. The contrast medium was conditioned as equally as used in the cerebral angio graphy. Injections of Ringer's solution were made to the 48 cases in order to com pare the results. The same examinations were performed also on 5 normal persons. 1) Significant changes in EEG were not observed in the normal persons. 2) EEG changes appeared in few cases with cerebrovascular diseases by injecting the Ringer's solution. 3) EEG alterations appeared in 33% of the cases with the cerebrovascular diseases during and/or after the injection of contrast medium. 4) Focal abnormality in EEG which was most frequently seen, appeared in 13 cases. It must be noted that the focal abnormality which had not been seen before, appeared after the injections, and that the extent of the appearance of the focal abnormality was considerably enlarged in some cases. Changes in frequency and amplitude of the basic waves were found in 4 cases. Bilateral spike appeared in one case. 5) The kinds and degrees of the clinical symptoms were not asso ciated with the appearance of EEG abnormality. As to the relationship between the appearance rate of abnormal EEG and the kinds of the diseases, the rate in the cerebral hemorrhage showed insignificant differences from that in cerebrovascular disease, though the former was slightly lower.
    [Show full text]