Digital subtraction angiography

Digital subtraction angiography (DSA) is a type of fluoroscopy technique used in interventional radiology to clearly visualize blood vessels in a bony or dense soft tissue environment. Images are produced using contrast medium by subtracting a 'pre-contrast image' or the mask from later images, once the contrast medium has been introduced into a structure. Hence the term 'digital subtraction angiography.

DSA identifies vascular pathology in 13% of patients with CTA-negative SAH. Intracranial aneurysms or pseudoaneurysms are identified in an additional 4% of patients by repeat DSA following an initially negative DSA. All patients with CT-negative SAH should be considered for DSA. The pattern of SAH may suggest the cause of hemorrhage, and aneurysms should specifically be sought with diffuse or perimesencephalic subarachnoid hemorrhage 1).

see 3D-DSA.

Heit JJ, Pastena GT, Nogueira RG, Yoo AJ, Leslie-Mazwi TM, Hirsch JA, Rabinov JD. Cerebral Angiography for Evaluation of Patients with CT Angiogram-Negative Subarachnoid Hemorrhage: An 11-Year Experience. AJNR Am J Neuroradiol. 2015 Sep 3. [Epub ahead of print] PubMed PMID: 26338924.
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