Ishida Fujimaro, Kojima Tadashi, Kawaguchi Kenji, Hoshino Tamotsu, Murao Kenichi, Taki Waro
Department of Neurosurgery, Mie Prefectural General Medical Center, Yokkaichi, Mie, Japan.
Neurol Med Chir (Tokyo). 2003 Jul;43(7):369-72; discussion 373. doi: 10.2176/nmc.43.369.
Conventional digital subtraction angiography (DSA) identified a right carotid-cavernous fistula (CCF). Three-dimensional DSA (3D-DSA) was used to evaluate the CCF before treatment. The 3D-DSA images showed the anatomical relationship of the parent artery and the veins, which was difficult to understand on conventional DSA. The endoscopic image revealed the fistula and cavernous sinus. The direction and location of the fistula could be confirmed. However, the size of the fistula significantly varied depending on the adjustment of the window thresholds, so the balloon size could not be selected based on the images. Catheterization and subsequent embolization of the cavernous sinus with a detachable balloon via the femoral artery was successfully accomplished by referring to the 3D-DSA images.
传统数字减影血管造影（DSA）检查发现右侧颈内动脉海绵窦瘘（CCF）。在治疗前采用三维DSA（3D-DSA）对CCF进行评估。3D-DSA图像显示了供血动脉与静脉的解剖关系，这在传统DSA上难以理解。内镜图像显示了瘘口和海绵窦。可以确定瘘口的方向和位置。然而，瘘口的大小会因窗口阈值的调整而有显著变化，因此无法根据图像选择球囊大小。通过参考3D-DSA图像，经股动脉成功地用可脱性球囊对海绵窦进行了插管及后续栓塞。
