Abstract
From May, 1982 to May, 1983, 300 consecutive patients were examined by intravenous digital subtraction angiography (DSA) using the Philips DVI system, which had a 512×512 matrix for video-imaging. Of those patients, 160 were diagnosed as having ischemic cerebrovascular disease. Attention was focused on 17 cases who were treated by a extracranial-intracranial (EC-IC) bypass and 5 cases treated with vascular reconstruction in the neck. Forty ml of contrast material was injected as a bolus from the antecubital vein, and serial images were stored in the video-disk recording system. The postprocessing mode was used for image processing. In 10 preoperative patients the regional cerebral blood flow (rCBF) and DSA studies were compared.
Diagnostic accuracy of major artery occlusions was adequate both in the neck (2224, 92%) and the intracranial cavity (66, 100%). However, diagnosis by the DSA system of major artery stenosis in the neck and intracranial cavity was not adequate (less than 60% accuracy). Vascular perfusion patterns of DSA and rCBF data correlated well in 6 out of 10 preoperative patients. However, no correlation was found in patients with interhemispheric steal.
DSA could accurately diagnose the patency of a superficial temporal-middle cerebral arterial bypass and a venous graft. The amount of blood flow through a EC-IC bypass had good correlation with the preoperative cortical vascular perfusion in DSA.
DSA was useful as a relatively noninvasive diagnosis for the hemodynamic evaluation of patients with ischemic cerebrovascular diseases.
