title: CBCT-based 3D MRA and angiographic image fusion and MRA image navigation for neuro interventions.
abstract: Digital subtracted angiography (DSA) remains the gold standard for diagnosis of cerebral vascular diseases and provides intraprocedural guidance. This practice involves extensive usage of x-ray and iodinated contrast medium, which can induce side effects. In this study, we examined the accuracy of 3-dimensional (3D) registration of magnetic resonance angiography (MRA) and DSA imaging for cerebral vessels, and tested the feasibility of using preprocedural MRA for real-time guidance during endovascular procedures.Twenty-three patients with suspected intracranial arterial lesions were enrolled. The contrast medium-enhanced 3D DSA of target vessels were acquired in 19 patients during endovascular procedures, and the images were registered with preprocedural MRA for fusion accuracy evaluation. Low-dose noncontrasted 3D angiography of the skull was performed in the other 4 patients, and registered with the MRA. The MRA was overlaid afterwards with 2D live fluoroscopy to guide endovascular procedures.The 3D registration of the MRA and angiography demonstrated a high accuracy for vessel lesion visualization in all 19 patients examined. Moreover, MRA of the intracranial vessels, registered to the noncontrasted 3D angiography in the 4 patients, provided real-time 3D roadmap to successfully guide the endovascular procedures. Radiation dose to patients and contrast medium usage were shown to be significantly reduced.Three-dimensional MRA and angiography fusion can accurately generate cerebral vasculature images to guide endovascular procedures. The use of the fusion technology could enhance clinical workflow while minimizing contrast medium usage and radiation dose, and hence lowering procedure risks and increasing treatment safety.
authors: Beijing PLA Military General Hospital Affiliated Bayi Brain Hospital, Beijing The Second People's Hospital of Hefei, Hefei Siemens Ltd. China, Healthcare Sector General Hospital of Chinese People's Armed Police Forces, Beijing, China.
authors: Qiang
authors: Q
authors: Zhang
authors: Zhiqiang
authors: Z
authors: Zhang
authors: Jiakang
authors: J
authors: Yang
authors: Qi
authors: Q
authors: Sun
authors: Yongchun
authors: Y
authors: Luo
authors: Tonghui
authors: T
authors: Shan
authors: Hao
authors: H
authors: Zhang
authors: Jingfeng
authors: J
authors: Han
authors: Chunyang
authors: C
authors: Liang
authors: Wenlong
authors: W
authors: Pan
authors: Chuanqi
authors: C
authors: Gu
authors: Gengsheng
authors: G
authors: Mao
authors: Ruxiang
authors: R
authors: Xu
mesh_terms: D000328:Adult; D000368:Aged; D015901:Angiography, Digital Subtraction / Q000379:methods*; D002533:Cerebral Angiography / Q000379:methods; D015331:Cohort Studies; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D002532:Intracranial Aneurysm / Q000175:diagnosis* / Q000601:surgery; D018810:Magnetic Resonance Angiography / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012680:Sensitivity and Specificity