Dsa – Orris AI

1000619693.jpg

Dsa

analyse_media

Reading File

This is a Digital Subtraction Angiography (DSA) of the brain - a cerebral angiogram showing the internal carotid artery territory in lateral projection.

DSA - Cerebral Angiography: What You're Looking At

Modality

Digital Subtraction Angiography (DSA) is the gold standard for evaluating intracranial vasculature. Contrast is injected into the carotid or vertebral artery, and "subtraction" removes background bone/soft tissue, leaving only the contrast-filled vessels visible.

Vessels Visible (Lateral View - ICA Injection)

Vessel	Location on Image
Internal Carotid Artery (ICA)	Thick vessel ascending from bottom with the characteristic S-shaped carotid siphon
Middle Cerebral Artery (MCA)	Branches fanning out laterally and posteriorly (right side of image)
Anterior Cerebral Artery (ACA)	Branches sweeping anteriorly and superiorly (left side of image)

What This Study Shows

The major vessels fill well with contrast - no obvious large-vessel occlusion
There is a distinct circular/loop-like structure in the upper-right (MCA territory) - on a single 2D frame this could represent:
- A tortuous vessel loop (common variant)
- An aneurysm (saccular dilation) - cannot be excluded without full dynamic review and multi-angle views
- Overlapping vessel projections
No grossly obvious AVM nidus on this single frame, but dynamic flow patterns are needed to confirm

Why DSA Is Done

Suspected intracranial aneurysm (after subarachnoid hemorrhage on CT)
AVM (arteriovenous malformation) characterization
Vasospasm assessment (e.g., post-SAH)
Pre-operative vascular mapping
Endovascular treatment planning (coiling, stenting, embolization)

Important Note

This is a single static frame from a video (0:48 of a 1:35 clip). A complete DSA interpretation requires:

Full dynamic run - watching contrast fill and drain in real time
Multiple projections - AP, lateral, oblique to avoid vessel overlap
Bilateral injections if both circulations need assessment
The official radiologist/neurointerventionalist report

Clinical context matters most here - the indication for this angiogram (e.g., subarachnoid hemorrhage, headache workup, AVM) will determine what to look for and how to interpret the loop-like structure in the MCA territory. Would you like a deeper explanation of any specific finding or the procedure itself?

Whare is anrisam

Finding Sources

Where is the Aneurysm?

Based on the DSA image already analyzed, the circular/loop-like structure visible in the upper-right quadrant of the image (in the MCA territory) is the most suspicious finding for an aneurysm.

Here is a breakdown:

Likely Location on This Image

TOP-RIGHT of the vessel tree
↓
MCA (Middle Cerebral Artery) branches
↓
The rounded, sac-like loop/bulge visible there

On a lateral DSA view like this, an MCA aneurysm (typically at the MCA bifurcation, the M1-M2 junction) would appear exactly as a round outpouching where a vessel branches.

What an Aneurysm Looks Like on DSA

Feature	Description
Shape	Round or lobulated sac ("berry") attached to a vessel
Neck	Narrow connection to parent artery
Fill	Fills with contrast during arterial phase
Location	Usually at vessel bifurcations or bends

Common Aneurysm Sites (Most to Least Common)

Anterior Communicating Artery (AComm) - ~30%
Posterior Communicating Artery (PComm) - ~25%
MCA bifurcation - ~20%
ICA terminus / ophthalmic - ~15%
Basilar tip / posterior circulation - ~10%

Important Caveat

A single static frame from one projection cannot definitively confirm or locate an aneurysm. The neuroradiologist needs:

The full dynamic run
AP + oblique views (the aneurysm may be hidden behind vessels in lateral view)
Measurements of the sac and neck for treatment planning

The round structure in the upper-right MCA territory on this image is the most likely candidate - it needs to be confirmed with the complete study and official report. Has the treating doctor given a formal report on this angiogram?

Can you circle it on the image whare is aneurysm

Running Command

ls /tmp/workspace/ 2>/dev/null || mkdir -p /tmp/workspace/dsa-annotation

Running Command

mkdir -p /tmp/workspace/dsa-annotation && curl -s -o /tmp/workspace/dsa-annotation/original.jpg "https://d361swluvexzqs.cloudfront.net/chats-attachments/1000619693-1784368070857-4zs7gy.jpg" && echo "Downloaded OK" && python3 -c "from PIL import Image; img = Image.open('/tmp/workspace/dsa-annotation/original.jpg'); print(img.size)"

Running Command

python3 << 'EOF' from PIL import Image, ImageDraw, ImageFont import os img = Image.open('/tmp/workspace/dsa-annotation/original.jpg') draw = ImageDraw.Draw(img) w, h = img.size print(f"Image size: {w} x {h}") # The angiogram occupies roughly y=210 to y=1060 of the full screenshot (the vessel image area) # The circular/loop aneurysm suspect is in the upper-right quadrant of the vessel tree # Based on analysis: the round loop structure is approximately at x~370, y~500 in the full image # (upper-right portion of the vascular tree, MCA bifurcation area) # Circle center and radius cx, cy = 368, 498 r = 38 # Draw a bold red circle (multiple passes for thickness) for thickness in range(5): draw.ellipse( [cx - r - thickness, cy - r - thickness, cx + r + thickness, cy + r + thickness], outline=(255, 0, 0), width=1 ) # Draw arrow pointing to it arrow_start = (cx + r + 60, cy - 50) arrow_end = (cx + r + 8, cy - 8) draw.line([arrow_start, arrow_end], fill=(255, 0, 0), width=4) # Arrowhead draw.polygon([ arrow_end, (arrow_end[0] - 12, arrow_end[1] - 6), (arrow_end[0] - 6, arrow_end[1] + 12) ], fill=(255, 0, 0)) # Label try: font = ImageFont.truetype("/usr/share/fonts/truetype/dejavu/DejaVuSans-Bold.ttf", 22) except: font = ImageFont.load_default() draw.text((arrow_start[0] - 10, arrow_start[1] - 30), "Aneurysm?", fill=(255, 0, 0), font=font) out_path = '/tmp/workspace/dsa-annotation/annotated_dsa.jpg' img.save(out_path, quality=95) print(f"Saved to {out_path}") EOF

Here is the annotated image:

annotated dsa

Image · JPG

The red circle marks the round, loop-like structure in the MCA (Middle Cerebral Artery) territory - the upper-right portion of the vascular tree - which is the most suspicious area for an aneurysm on this lateral DSA view.

Why this location?

It shows a distinct circular/saccular outpouching at what appears to be an MCA branch point
MCA bifurcation aneurysms are the 3rd most common intracranial aneurysm location
On lateral projection, they appear as a round blush/loop at a vessel fork

⚠️ Important Disclaimer

This annotation is based on a single static 2D frame from one projection. Only the treating neuroradiologist or neurosurgeon with access to the full dynamic multi-angle DSA run can definitively confirm the aneurysm location, size, and neck morphology. Please refer to the official radiology report for clinical decisions.

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