Oblique positioning for intravenous digital subtraction angiography images of the neck and head

Oblique intravenous digital subtraction arteriography (IV-DSA) images of the neck were entered high to include the carotid bifurcations and siphons on one view in 80 consecutive patients being investigated for cerebral vascular atherosclerosis. Using a 27 cm image intensifier, these two important areas for atherosclerotic involvement were seen together on 68.1 percent of the images. In 25.6 percent of the images, the centering was too low to include the siphons on the film due to incorrect interpretation of facial anatomy on the oblique scout view. Careful attention to anatomic detail will allow correct centering in most patients. This will allow the bifurcations and siphons to be seen in profile together, thereby decreasing the number of film runs needed and the contrast volume given