Respiratory Stereoscopy in Abdominal Angiography

Abstract
Stereoscopic films have long been used in roentgenography to evaluate complex anatomical detail. Chase and Taveras (1) outlined methods of obtaining stereoscopic serial cerebral angiograms and described a relatively inexpensive method of securing stereoscopic films by moving the patient between exposures. To our knowledge stereoscopy has not been applied to abdominal angiography. The plethora of overlapping vessels visualized during abdominal angiography makes evaluation, particularly of the smaller arteries of the celiac and superior mesenteric distribution, difficult. It is obvious that stereoscopic films would be of great assistance in better localizing and following the course of these vessels. We are currently evaluating several methods of obtaining such roentgenograms. Attempts at adopting the method used by Chase and Taveras have been unsuccessful in abdominal angiography. Lack of success is probably due to persistence of body motion after the table top stops, with a reciprocating rate of 2 films per second. The use of two separate anodes making alternate exposures is currently being evaluated. The following method for obtaining stereoscopic films during serial abdominal angiography involves no additional equipment and is easy to perform. Technic In our department serial films are taken at half-second intervals during the arterial phase. The stereoscopic shift is obtained by having the patient suspend respiration in full expiration for several seconds, then quickly inhale and suspend respiration in inspiration for the remainder of the filming sequence. If exposure times of one-twentieth of a second or less are used, none of the films are blurred because of motion. The respiratory excursion of the diaphragm is sufficient to displace most of the abdominal organs (stomach, small intestine, liver, spleen, pancreas, and kidneys) several centimeters and allows a stereoscopic effect. A pair of films, one in the inspiration phase and one in the expiration phase, with similar arterial filling, are selected for stereoscopic viewing. Since the lumbar vertebrae do not move significantly during respiration, they serve as useful landmarks to evaluate the degree of shift of vessels and to select a proper pair of films for stereoscopic viewing. Application Respiratory stereoscopic serial angiography has been applied to abdominal aortography, selective celiac, superior mesenteric, and renal arteriography. The method has been valuable for the separation of multiple superimposed arteries and is particularly helpful in delineation of the smaller arteries of the celiac axis. Although this method does not provide true stereoscopic films and the exact depth of a particular structure cannot be stated, the relative depth between structures is demonstrated (Figs. 1 and 2). Summary A simple and inexpensive method of obtaining stereoscopic films during serial abdominal angiography utilizing respiratory displacement of the viscera is presented.