Neurovascular imaging

Vascular anomalies (some of these are called "birthmarks") and other abnormalities of the blood vessels in the head, neck, and spinal areas may need evaluation in children. There are many ways imaging is available for studying the arteries, capillaries, veins, and lymphatic vessels in children.

A lot of information may be from normal ultrasound, magnetic resonance, and CT imaging but specific edits of these methods designed to look at the vessels have shown to be very useful.

There are many types of magnetic resonance angiography (MRA) that can be useful and do not need to go into an artery to get a diagnostic study (they are "non-invasive"). Non-invasive simply means that doctor's tools will not be needed in the body. One type of MRA we use does not even need intravenous contrast injection. Another type of MRA that was formed here, multi-phase magnetic angiography, uses only an intravenous injection of contrast agent and then an image series is obtained at small intervals as little as one per second. This latter safe method has proven to be very valuable in studies performed at Children's Wisconsin. Pediatric institutions throughout the world are continuing to follow our lead in this technique. There are several ways to look at the veins, which is called magnetic resonance venography. One method of magnetic resonance venography does not need an injection of contrast into the veins, but it may be easier to do a study with the injection.

Similarly, CT studies for the arteries and veins can be performed following the intravenous injection of contrast material (CT angiography and venography).

Finally, Doppler ultrasound can be very helpful in the neuroradiological assessment of vascular flow and vessel evaluation. Ultrasound, like CT and MR, is also considered "non-invasive."

Conventional angiography may be needed on occasion because of the superior x-ray imaging it offers, but it is an "invasive" method. It does require inserting a catheter (small tube) following puncture of a leg artery and then passing this catheter throughout the body to assess arterial aneurysms, occlusions or blockages, vascular malformations, and other vascular lesions, including those in the head, neck, and spinal region. Conventional venography requires venopuncture. Although these methods are considered "invasive," our experienced interventionalists here have a great record of safety in doing them.

Many of the methods above are used in surgical and neurointerventional treatment of a wide variety of vascular lesions.