Twenty-five patients (aged from two days after birth to twelve years) were studied. The contrast material was injected into a vein in 21 patients and into an artery in the other 4. Amipaque (2mg/kg) followed by 4ml of saline was injected intravenously. We recorded the digital subtraction angiography images on videotape and analyzed them with a Nexus Image Processor and a Vak-11/750 computer. The region of interest (ROI) was set at the supraclinoid portion of the internal carotid and sinus confluence. Time-density curves were obtained for two ROIs, and cerebral circulation Time (CCT) was measured as the time from the carotid peak to the sinus peak.
Images of the diagnostic value were obtained in 16 patients in whom the contrast material was injected into the carotid artery, superior vena cava or peripheral vein at the elbow. The images obtained in patients in whom the contrast material was injected into the peripheral vein on the hand were of no value. No advers effects were seen when the total injection volume was limited to 4ml/Kg. CCT was measured in 14 patients. In 9 patients, no cerebrovascular disease was disclosed, the mean CCT in this group was 4.3±0.54 sec with a range of 3.73 to 5.06 sec. The prolongation of CCT was found in patients with superior sagittal sinus thrombosis, moyamoya disease and frontal hematoma. The mean CCT in this group was 6.1±2.48 sec.
DSA was useful for diagnosing cerebrovascular diseases in neonates and children. In addition, measurement of CCT was very useful for quantitating the cerebral circulation in pediatric patients.