Satoh Toru, Omi Megumi, Ohsako Chika, Katsumata Atsushi, Yoshimoto Yusuke, Tsuchimoto Shoji, Onoda Keisuke, Tokunaga Koji, Sugiu Kenji, Date Isao
Department of Neurological Surgery, Ryofukai Satoh Neurosurgical Hospital, Fukuyama-city, Hiroshima 729-0104, Japan.
No Shinkei Geka. 2005 Jun;33(6):569-77.
The anatomical relationship of an unruptured internal carotid-posterior communicating artery aneurysm and the perianeurysmal environment was investigated by using three-dimensional (3D) magnetic resonance cisternography (MRC), angiography (MRA) and newly developed fusion images of 3D MRC and 3D MRA. Contact of an aneurysm with the adjacent intra- and pericisternal structures was observed in cases with the aneurysm developing and extending beyond the capacity of the surrounding subarachnoid space. Deformation and bleb formation of the aneurysmal dome was depicted at the dome in contact with the perianeurysmal environment, including the tentorial edge, the anterior petroclinoid dural fold, the oculomotor nerve, the posterior clinoid process, the dorsum sellae and the cranial base bone. By using the fusion imaging technique of 3D MRC and 3D MRA, assessment of the contact of an unruptured cerebral aneurysm with its perianeurysmal environment can be made. Such contact gives ride to risk of deformation and bleb formation of the aneurysmal dome; and may result in cranial nerve symptoms and accelerate rupture from an unruptured cerebral aneurysm.
采用三维(3D)磁共振脑池造影(MRC)、血管造影(MRA)以及新开发的3D MRC与3D MRA融合图像,研究未破裂颈内动脉-后交通动脉瘤的解剖关系及其瘤周环境。在动脉瘤发展并超出周围蛛网膜下腔容纳能力的病例中,观察到动脉瘤与相邻的脑池内和脑池周围结构接触。在与瘤周环境(包括小脑幕边缘、岩骨前床突硬脑膜皱襞、动眼神经、后床突、鞍背和颅底骨)接触的动脉瘤瘤顶处,显示出瘤顶的变形和小泡形成。通过使用3D MRC和3D MRA融合成像技术,可以评估未破裂脑动脉瘤与其瘤周环境的接触情况。这种接触会增加动脉瘤瘤顶变形和形成小泡的风险;并可能导致颅神经症状,加速未破裂脑动脉瘤的破裂。