Diagnostic Value of the Digital Subtraction Angiography of Brain Tumors

Digital subtraction angiography (DSA) in 110 cases of brain tumors were studied in comparison with conventional angiography (CA). The dural sinuses and tumor stains of meningiomas, particularly tuberculum sellae meningioma, were better shown by intravenous DSA (IV-DSA) than by CA. IV-DSA clearly demonstrated bilateral carotid arteries and was able to rule out the coexistence of the intracranial aneurysm in 88% of 32 cases with pituitary adenomas. Combination of IV-DSA and high resolution computed tomography has replaced CA to determine surgical indication of patients with pituitary adenomas. Intra-arterial DSA (IA-DSA) was diagnostic and well comparable to CA in identifying main cerebral vasculature over 1 mm in diameter. As to the small arteries under 1 mm and fine tumor vessels, IA-DSA provided less information or none at all. However, IA-DSA was superior to CA for visualization of tumor stains. Not only in most of meningiomas and hemangioblastomas, but in some astrocytomas and oligodendrogliomas, marked tumor stains were well demonstrated on DSA, and DSA provided surgical anatomy for neurosurgeons because of high contrast resolutions. Careful attention should be paid because tumor stains may overestimate tumor vascularity.