Chung Jung Lin MD, Presenter: Research support, Siemens AG

Wan-Yuo Guo MD, Abstract Co-Author: Software support, Siemens AG

Feng-Chi Chang, Abstract Co-Author: Nothing to Disclose

Chao-Bao Luo, Abstract Co-Author: Nothing to Disclose

Sheng Che Hung MD, Abstract Co-Author: Nothing to Disclose

Wei-Fa Chu BA, Abstract Co-Author: Nothing to Disclose

Cheng-Yen Chang MD, Abstract Co-Author: Nothing to Disclose

To define the role of color-coded QDSA in evaluating the therapeutic effects of various brain vascular disorders.

85 patients with brain disorders that necessitated DSA were recruited. They were 15 arteriovenous malformations/fistulae (group A), 20 occlusive diseases (group B) and 50 without DSA detectable abnormal circulation time (group C, for control). The angio-catheters were placed at C4 vertebral body level for angiography (6 frames/sec using AXIOM-Artis® angiosystem, Siemens Healthcare)with total amount of 12 ml (for carotid) and 9 ml (for vertebral) 60% diluted contrast medium (340 mgI/ml) administrated in 1.5 sec by a power injector. Post-processing software (iFlow®, Siemens Healthcare) was used to define the time of maximal intensity (Tmax in sec) at selected angiographic mark points, namely, cavernous portion (I1) , supraclinoid (I2) portion of the internal carotid artery (ICA), proximal (A1) and distal (A2) anterior cerebral artery, first (M1) and second (M2) portions of middle cerebral artery, cortical vein at the parietal (CVP), superior sagittal sinus (SSS) and internal jugular vein(IJV). The Tmax of each mark point was stemmed from the average of six measurements, performed by two neuroradiologists (three times each). Tmax’s of each mark point between groups A, B and C, defined as circulation time, were compared (Wilcoxon Two-Sample Test). Longitudinal comparison of groups A with de-vascularization treatments and group B with re-vascularization treatments was performed to define the therapeutic effects on circulation time.

Tmax’s of group C at each mark point (I1: 0.06, I2: 0.13, A1: 0.29, A2: 0.97, M1: 0.49, M2: 0.99, CVP: 4.86, SSS: 5.92, IJV: 6.55). Tmax’s of feeders, drainers, SSS, and IJV in group A were all shorter than group C (p<0.05) and reversed towards normalization after treatment (p= 0.38). Tmax’s of affected arteries and downstream veins were prolonged in group B (p<0.05) and shortened towards normalization after treatments (p= 0.03). Post-therapeutic Tmax’s of groups A and B were not different from group A (p= 0.61).

QDSA provides reliable and objective monitoring on circulation time for managing brain vascular disorders

Color-coded QDSA provides physiological details in a single image. In-room and real time quantitative analysis of intracranial circulation time becomes feasibly achievable in clinical routine.

Lin, C, Guo, W, Chang, F, Luo, C, Hung, S, Chu, W, Chang, C, Toward Normalization of Intracranial Circulation Time: The Therapeutic Effects of Brain Vascular Disorders Evidenced by Color-Coded Quantitative Digital Subtraction Angiography (QDSA).  Radiological Society of North America 2011 Scientific Assembly and Annual Meeting, November 26 - December 2, 2011 ,Chicago IL. http://archive.rsna.org/2011/11004063.html