Digital Subtraction Angiography in Cerebral Infarction

ABSTRACT

PURPOSE: The usefulness and radiographic findings of the angiography in cerebral infarction are well known. We attempted to evaluate the anglographic causes, findings, and the usefulness of DSA in cerebral infarction. MATERIALS AND METHODS: The authors reviewed retrospectively DSA images of 51 patients who were diagnosed as having cerebral infarction by brain CT and/or MRI and clinical settings. DSA was performed in all 51 patients, and in 3 patients, conventional anglogram was also done. Both carotid DSA images were obtained in AP, lateral, oblique projections, and one or both vertebral DSA images in AP and lateral. The authors reviewed the patient's charts for symptoms, operative findings and final diagnosis, and analysed DSA findings of cerebral atherosclerosis with focus on 6 major cerebral arteries. RESULTS: Among the 51 patients of cerebral infarction 43 patients(84.3%) had cerebral atherosclerosis, 1 dissecting aneurysm, 1 moyamoya disease and 6 negative in anglogram. DSA findings of cerebral atherosclerosis were multiple narrowings in 42 patients(97,7%), tortuosity in 22(51.2%), dilatation in 14, occlusion in 12, avascular region in 8, collaterals in 7, ulcer in 6, and delayed washout of contrast media in 3. In cerebral atherosclerosis, internal carotid artery was involved in 37 patients(86.0%), middle cerebral artery in 29(67.4%), posterior cerebral artery in 28, anterior cerebral artery in 26, vertebral artery in 22, and basilar artery in 15. Intracranial involvement of cerebral atherosclerosis (64.9%) was more common than extracranial involvement(16.2%). CONCLUSION: In cerebral infarction MRA may be the screening test, but for more precise evaluation of vascular abnormality and its extent, DSA should be considered.