Cerebral angiography recorded cinefluorographically.

Abstract

T HE purpose of this paper is to report progress in the development of a successful cinefluorographic method of cerebral arteriography. Stationary records of the shadows of brain vessels as obtained in the conventional method of single or even repeated roentgen-ray exposures allow only glimpses of the vascular flow of a contrast medium. Although in many instances such glimpses reveal sufficient information for diagnosis, frequently, because of faulty timing, these glimpses are not enough. Efforts to overcome this deficiency have been largely in the direction of increasing the number of exposures during the injection, repeating the injection of the dye and secondary injections for stereoscopic views. Most of these efforts have further complicated the technique. The ult imate aim has been to obtain a continuous record of the flow of radiopaque dye through the vessels of the brain. The potential yield of information from such a record might go far beyond the identification of pathological vascular configurations. The need for the development of such a technique has been recognized before but to our knowledge only one a t t empt at producing one for practical use has thus far been reported. This was by Holm 1 in 1944. He also used the indirect method of photographing the images on a fluorescent screen and took 8 or 16 frames per second. Although he was able to obtain some records he admit ted that the quality of the films was not adequate to permit the clinician to rely on this technique alone and recommended its use as a complement to the conventional method. With the development at Strong Memorial Hospital of a practical cinefluorographic apparatus it has now become possible to make continuous cerebral arteriographic records that are satisfactory for clinical use. Earlier publications have described the technical construction of this apparatus in detail. 2 We have employed this method thus far in obtaining ~0 satisfactory angiograms. By preference we have used the percutaneous method exclusively although the direct surgical exposure technique is equally suitable.