✓ Angiography is often performed to identify the vascular supply of hemangioblastomas prior to resection. Conventional two-dimensional (2D) digital subtraction (DS) angiography and three-dimensional (3D) DS angiography provides high-resolution images of the vascular structures associated with these lesions. However, such 3D DS angiography often does not provide reliable anatomical information about nearby osseous structures, or when it does, resolution of vascular anatomy in the immediate vicinity of bone is sacrificed. A novel angiographic reconstruction algorithm was recently developed at The Johns Hopkins University to overcome these inadequacies. By combining two separate sequences of images of bone and blood vessels in a single 3D representation, 3D fusion DS (FDS) angiography provides precise topographic information about vascular lesions in relation to the osseous environment, without a loss of resolution.
In this paper, the authors present the cases of two patients with cervical spine hemangioblastomas who underwent preoperative evaluation with FDS angiography and then successful gross-total resection of their tumors. In both cases, FDS angiography provided high-resolution 3D images of the hemangioblastoma anatomy, including each tumor’s topographic relationship with adjacent osseous structures and the location and size of feeding arteries and draining veins. These cases provide evidence that FDS angiography represents a useful adjunct to magnetic resonance imaging and 2D DS angiography in the preoperative evaluation and surgical planning of patients with vascular lesions in an osseous environment, such as hemangioblastomas in the spinal cord.
Abbreviations used in this paper:CT = computed tomography; DS = digital subtraction; FDS = fusion DS; MR = magnetic resonance; VA = vertebral artery; 2D = two-dimensional; 3D = three-dimensional.
Address reprint requests to: Jean-Paul Wolinsky, M.D., Department of Neurosurgery, The Johns Hopkins University School of Medicine, Meyer Building, Room 7–109, 600 North Wolfe Street, Baltimore, Maryland 21287. email:
GailloudPOishiSCarpenterJMurphyKJ: Three-dimensional digital angiography: new tool for simultaneous three-dimensional rendering of vascular and osseous information during rotational angiography. AJNR Am J Neuroradiol25:571–5732004
GailloudP, OishiS, CarpenterJ, MurphyKJ: Three-dimensional digital angiography: new tool for simultaneous three-dimensional rendering of vascular and osseous information during rotational angiography. 25:571–573, 2004)| false
GailloudPOishiSMurphyK: Three-dimensional fusion digital subtraction angiography: new reconstruction algorithm for simultaneous three-dimensional rendering of osseous and vascular information obtained during rotational angiography. AJNR Am J Neuroradiol26:908–9112005
GailloudP, OishiS, MurphyK: Three-dimensional fusion digital subtraction angiography: new reconstruction algorithm for simultaneous three-dimensional rendering of osseous and vascular information obtained during rotational angiography. 26:908–911, 2005)| false