V. Virtual angioscopy with intravascular and extravascular computer generated videoangioscopy

PURPOSE: To videoscopically explore the outside and inside of 2 mm and larger blood vessels in the skull base and circle of Willis by simulated computer generated angioscopy (CGA) in normal and aneurysm populations as a diagnostic and preoperative tool. METHODS: Thin-section helical computerized tomographic angiography of the supracervical internal carotid artery was performed with spiral CT Angiography using a power injected intravenous contrast Material bolus. This data was transferred to an Infinite Reality workstation for extravascular perspective generation, and intravascular visualization. Key perspectives were selected, and a dynamic "flight" model was generated along juxtavascular and intravascular paths. The flight paths demonstrate specific anatomic regions of interest. RESULTS: Normal vasculature down to 2 millimeter vessel diameters is demonstrated from without and from within. With aneurysm samples, specific visualization of the native vessel, fundus, axilla, and aneurysm neck are internally and externally possible. CONCLUSIONS: Virtual videoangioscopic images hold promise for improving the diagnostic evaluation of vascular anatomy and pathology. These advantages may prove to be of considerable benefit in planning and followingup endovascular and conventional vascular surgical procedures.