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, Hiroshima, Japan.
AJNR Am J Neuroradiol. 2005 Sep;26(8):2010-8.
Surface irregularity and bleb formation are anatomical factors that are associated with aneurysm rupture. The perianeurysmal environment has been proposed as one factor that may influence aneurysm morphology. We have developed a fusion imaging technique of 3D MR cisternography and angiography that allows clear visualization of an aneurysm and its environment. This technique may prove useful in further understanding of the natural history of intracranial aneurysms.
Fusion images of 3D MR cisternography and angiography were reconstructed by a perspective volume-rendering algorithm from the volume datasets of MR cisternography, obtained by a T2-weighted 3D fast spin-echo sequence, and coordinated MR angiography, by a 3D time-of-flight sequence. On the fusion images, the anatomic relationship of an aneurysm to the perianeurysmal structures was assessed, and the influence of perianeurysmal environment on the deformation and bleb formation of the aneurysm was investigated.
Marked and minor deformation and bleb formation of the aneurysmal dome were found at the areas confronted or adjacent to a certain contact with perianeurysmal structures, including cranial nerves, brain parenchyma, cranial base bones, petroclinoidal dural folds, and dura mater.
Fusion images of 3D MR cisternography and angiography can depict the contact of an aneurysm with its perianeurysmal environment; this may provide an additional parameter in consideration for the natural history of cerebral aneurysms.
表面不规则和小泡形成是与动脉瘤破裂相关的解剖学因素。有人提出瘤周环境是可能影响动脉瘤形态的一个因素。我们开发了一种三维磁共振脑池造影和血管造影的融合成像技术，该技术能够清晰显示动脉瘤及其周围环境。这项技术可能有助于进一步了解颅内动脉瘤的自然病程。
通过透视容积再现算法，从采用T2加权三维快速自旋回波序列获得的磁共振脑池造影容积数据集以及采用三维时间飞跃序列的协同磁共振血管造影中重建三维磁共振脑池造影和血管造影的融合图像。在融合图像上，评估动脉瘤与瘤周结构的解剖关系，并研究瘤周环境对动脉瘤变形和小泡形成的影响。
在与瘤周结构（包括脑神经、脑实质、颅底骨、岩床硬脑膜皱襞和硬脑膜）存在一定接触的相对或相邻区域，发现动脉瘤穹隆有明显和轻微的变形及小泡形成。
三维磁共振脑池造影和血管造影的融合图像能够描绘动脉瘤与其瘤周环境的接触情况；这可能为考虑脑动脉瘤的自然病程提供一个额外参数。
