A novel image fusion visualizes the angioarchitecture of the perforating arteries in the brain

Abstract

We report a novel technique that fuses 3D digital subtraction angiograms and MR images. Image fusion was successfully performed within 20 minutes each in 11 consecutive cases. Our initial experience showed that this image fusion enabled clear and simultaneous visualization of perforating arteries and surrounding tissues. The relation between perforating arteries and normal brain or lesions was easily understood in a clinical setting by using this image fusion.

Fig 1.

Images in a patient with no pathology (contralateral side of a right ICA aneurysm, which was treated with endovascular obliteration). A, 3D DSA (volume rendering) image, which can be seen stereoscopically, clearly shows one left RAH and one left LSA (upper, anteroposterior view; lower, posteroanterior view). B, Common cursor image, which simultaneously displays 3D DSA (MIP), axial, and coronal contrast-enhanced MR images, clearly shows the passing course of the left RAH (short arrow, origin of the RAH; long arrow, top of the cranial loop; arrowhead, immediately before entering the anterior perforating substance; double arrow, location at the putamen). The corresponding points are indicated as small red dots. C, Common cursor image clearly shows the passing course of the left LSA (short arrow, location in the sylvian fissure; long arrow, location at the anterior perforating substance; arrowhead and double arrow, locations at the putamen). The corresponding points are indicated as small red dots.

Fig 2.

Common cursor image in a patient with a right thalamic malignant lymphoma. The image, which simultaneously displays 3D DSA (MIP) and axial contrast-enhanced MR images, clearly shows the relation between the tumor and two LSAs (long arrow and arrowhead) or one RAH (short arrow). The corresponding points are indicated as small red dots.