Optimization of image shoot timing for cerebral veins 3D-digital subtraction angiography by interventional angiography systems

Abstract

Abstract3D-digital subtraction angiography (3D-DSA) is essential for understanding the anatomical structure of cerebral veins, crucial in brain tumor surgery. 3D-DSA produces three-dimensional images of veins by adjusting the X-ray delay time after contrast agent injection, but the delineation of veins varies with the delay in X-ray timing. Our study aimed to refine the delay time using time-enhancement curve (TEC) analysis from 2D-DSA conducted before 3D-DSA imaging. We retrospectively reviewed 26 meningioma patients who underwent cerebral angiography from March 2020 to August 2021. Using 2D-DSA, we analyzed arterial and venous TECs to determine the contrast agent’s peak time and estimated the optimal imaging timing. Cases performed near this optimal time were in Group A, and others in Group B, with cerebral venous pixel values compared between them. TEC analysis identified peak times: internal carotid artery: 2.8 ± 0.7 s, middle cerebral artery (M4): 4.1 ± 0.9 s, superior sagittal sinus: 8.3 ± 1.1 s, sigmoid sinus: 9.5 ± 1.3 s, and venous structures near tumors: 7.3 ± 1.0 s. We observed several veins peaking immediately after arterial contrast passage, suggesting the optimal X-ray delay should incorporate the arterial contrast agent’s transit time. Statistical analysis revealed that Group A, with imaging timed to reflect the contrast agent transit time, demonstrated significantly better contrast effects than Group B. The X-ray delay time for 3D-DSA imaging of cerebral veins can be optimized in angiography systems by incorporating the contrast agent transit time, calculated from TEC analysis of cerebral 2D-DSA images.