title: Using DynaCT rotational angiography for angioarchitecture evaluation and complication detection in spinal vascular diseases.
abstract: OBJECTIVE
  Preoperative comprehension of the complex angioarchitecture and intraoperative complication detection are essential in endovascular treatment and surgical planning for spinal vascular diseases. We aimed to illustrate the application of DynaCT rotational angiography for the treatment of such diseases.
  
  
  METHODS
  We retrospectively analyzed the medical records of 23 patients with spinal vascular disease who underwent DynaCT and three-dimensional (3D) rotational angiography between January 2012 and December 2013. Diseases included spinal arteriovenous malformation, spinal dural arteriovenous fistula, and hypervascular neoplasm. Radiological post-processing images and procedural complications were reviewed to compare the advantage of rotational angiography and digital subtraction angiography (DSA).
  
  
  RESULTS
  Rotational angiography more clearly revealed the complex angioarchitecture in cases of spinal vascular diseases based on coronal, sagittal, and transverse views compared with DSA. Subarachnoid hemorrhage was confirmed with DynaCT in one patient with spinal arteriovenous malformation, which was not shown on DSA. Both two-dimensional and 3D angiograms effectively identified the fistulous points in five cases of spinal dural arteriovenous fistula while rotational angiography vividly demonstrated the relationship of the fistulous point with the osseous structures in dual-volume mode. Tumor feeders were clearly delineated in 3D reconstructed images and easily cauterized in patients with hemangioblastoma.
  
  
  CONCLUSIONS
  Rotational angiography clarified the relationship between the vasculature and surrounding osseous structures for surgical or endovascular therapy of spinal vascular diseases. DynaCT can detect intraoperative subarachnoid hemorrhage in a timely manner during endovascular treatment of spinal vascular diseases.
authors.affiliation: Neurosurgery Department, Changhai Hospital, Second Military Medical University, Shanghai 200433, China. Electronic address: zifuli2008@163.com.
authors.forename: Zi-Fu
authors.initials: ZF
authors.lastname: Li
authors.affiliation: Neurosurgery Department, Changhai Hospital, Second Military Medical University, Shanghai 200433, China. Electronic address: hongbosmmu@yeah.net.
authors.forename: Bo
authors.initials: B
authors.lastname: Hong
authors.affiliation: Neurosurgery Department, Changhai Hospital, Second Military Medical University, Shanghai 200433, China. Electronic address: xuyismmu@yahoo.com.cn.
authors.forename: Yi
authors.initials: Y
authors.lastname: Xv
authors.affiliation: Neurosurgery Department, Changhai Hospital, Second Military Medical University, Shanghai 200433, China. Electronic address: ocinhqh@163.com.
authors.forename: Qing-Hai
authors.initials: QH
authors.lastname: Huang
authors.affiliation: Neurosurgery Department, Changhai Hospital, Second Military Medical University, Shanghai 200433, China. Electronic address: doczhaowy@163.com.
authors.forename: Wen-Yuan
authors.initials: WY
authors.lastname: Zhao
authors.affiliation: Neurosurgery Department, Changhai Hospital, Second Military Medical University, Shanghai 200433, China. Electronic address: chstroke@163.com.
authors.forename: Jian-Min
authors.initials: JM
authors.lastname: Liu
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000792:Angiography / Q000295:instrumentation / Q000379:methods*; D001165:Arteriovenous Malformations / Q000000981:diagnostic imaging*; D020785:Central Nervous System Vascular Malformations / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional; D008297:Male; D008875:Middle Aged; D012399:Rotation; D020758:Spinal Cord Vascular Diseases / Q000000981:diagnostic imaging*; D055815:Young Adult
keywords: Angiography, digital subtraction; DynaCT; Imaging, three-dimensional; Spine