Three-Dimensional Fusion Digital Subtraction Angiography: New Reconstruction Algorithm for Simultaneous Three-Dimensional Rendering of Osseous and Vascular Information Obtained during Rotational Angiography

Philippe Gailloud; Satoru Oishi; Kieran Murphy

American Journal of Neuroradiology

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Fig 1.
Flowchart shows the three steps involved in 3D-FDSA image reconstruction. The first (outlined in blue) consists in a standard 3D-DSA reconstruction. The rotational mask acquisition is subtracted from the rotational contrast acquisition. The Feldkamp method is applied to the resulting subtracted rotational data set to obtain the 3D-DSA reconstruction. The second step (outlined in red) consists in the reconstruction of the rotational mask acquisition into a 3D osseous representation (3D-bone) by using a modified Feldkamp method. The third step (outlined in black) is the combination of the two 3D reconstructions obtained in step 1 and 2 into a fused 3D volume.
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Fig 2.
3D-FDSA a 32-year-old woman with a fusiform aneurysm of the left internal carotid artery. Representations on the workstation include 3D-FDSA, 3D-bone, and 3D-DSA modes.
A, Craniocaudal 3D-FDSA view of the skull base shows erosion of the basisphenoid due to expansion of the aneurysm (arrowheads).
B, Same view in 3D-bone mode better depicts the osseous erosion involving the basisphenoid (arrowheads), apex of the petrous bone (long arrow), and lateral aspect of the sphenoid body (short arrows).
C, Same view in 3D-DSA mode provides details of the vascular anatomy. Note decreased attenuation in the posterior aspect of the aneurysm (asterisk) corresponding to the stagnation of contrast agent in the declive portion of the sac, as seen on regular 2D-DSA (not shown).
D, 2D axial reformation of the 3D-FDSA data set (section thickness, 1 mm) reveals that the posterior aspect of the aneurysmal cavity, where contrast agent stagnation is shown, protrudes into the posterior fossa through the eroded basisphenoid (arrow).
E, 2D reformation of the 3D-FDSA data set (section thickness, 1 mm) in an oblique plane parallel to the axis of the petrous bone. Note the detailed rendering of the interface between bone and blood vessels as the carotid artery crosses the carotid canal. Also note the fine anatomic depiction of the inner ear structures.