Teksam Mehmet, McKinney Alexander, Truwit Charles L
Department of Radiology, University of Minnesota Medical School, Minneapolis, MN, USA.
Eur J Radiol. 2004 Dec;52(3):217-20. doi: 10.1016/j.ejrad.2003.12.003.
Multi-slice CT (MSCT) scanners provided significant improvement in vascular applications. In this study, our purpose was to determine the clinical utility of MSCTA in evaluation of extracranial-intracranial (EC-IC) bypass patency. Eleven (4 men and 7 women; mean age, 46 years; age range, 19-68 years) consecutive patients who underwent MSCTA and DSA after EC-IC bypass surgery were evaluated retrospectively. All patients underwent DSA within 3 weeks of MSCTA. The indications for EC-IC bypass were severe stenosis or occlusion of intracranial arteries in seven patients and therapeutic occlusion of intracranial artery for unclippable giant aneurysm in four patients. Ten patients underwent superficial temporal artery (STA)-middle cerebral artery (MCA) bypass and one patient underwent occipital artery-posterior cerebral artery (PCA) bypass. Eight STA-MCA bypasses in six patients were patent on MSCTA which were confirmed on DSA. Two STA-MCA bypasses and one occipital artery-posterior cerebral artery (PCA) bypass were occluded in three patients on MSCTA and DSA. In one patient, minimal stenosis of the STA-MCA bypass was identified on MSCTA and DSA. In 1 patient, STA-MCA bypass was not well seen on MSCTA and suspected for occlusion. DSA identified the occlusion of bypass on this patient. MSCTA seems to be a very promising noninvasive technique in evaluation of EC-IC bypass.
多层螺旋CT（MSCT）扫描仪在血管成像应用方面有显著改进。在本研究中，我们的目的是确定MSCT血管造影（MSCTA）在评估颅外-颅内（EC-IC）旁路通畅性方面的临床应用价值。对11例（4例男性和7例女性；平均年龄46岁；年龄范围19 - 68岁）连续接受EC-IC旁路手术后进行了MSCTA和数字减影血管造影（DSA）检查的患者进行回顾性评估。所有患者在MSCTA检查后3周内接受了DSA检查。EC-IC旁路手术的适应证为7例患者颅内动脉严重狭窄或闭塞，4例患者因无法夹闭的巨大动脉瘤而进行颅内动脉治疗性闭塞。10例患者接受了颞浅动脉（STA）-大脑中动脉（MCA）旁路手术，1例患者接受了枕动脉-大脑后动脉（PCA）旁路手术。6例患者的8条STA-MCA旁路在MSCTA上显示通畅，并经DSA证实。3例患者的2条STA-MCA旁路和1条枕动脉-大脑后动脉（PCA）旁路在MSCTA和DSA上均显示闭塞。1例患者在MSCTA和DSA上均发现STA-MCA旁路有轻度狭窄。1例患者的STA-MCA旁路在MSCTA上显示不清，怀疑闭塞，DSA证实该患者旁路闭塞。MSCTA似乎是评估EC-IC旁路的一种非常有前景的无创技术。
