Shi Wan-Yin, Li Yong-Dong, Li Ming-Hua, Gu Bin-Xian, Wang Wu, Zhang Bei-Lei, Li Min
Institute of Diagnostic and Interventional Radiology, The Sixth Affiliated People's Hospital, Shanghai Jiao Tong University, No 600, Yi Shan Road, Shanghai 200233, China.
Surg Radiol Anat. 2011 Jan;33(1):75-80. doi: 10.1007/s00276-010-0728-z. Epub 2010 Sep 21.
Whether an infundibular dilation (ID) is an anatomical variant or a pre-aneurysm has not been clearly determined. The aim of the present study was to evaluate the anatomical change of IDs by use of three-dimensional rotational angiography (3DRA) with volume rendering (VR).
One-hundred thirty-eight patients with known or suspected aneurysms, treated consecutively, underwent both two-dimensional digital subtraction angiography (2DDSA) and 3DRA with VR. Two readers evaluated the IDs or aneurysms blindly, using 2DDSA and 3DRA, according to the same diagnostic criteria. A 5-point scale of observer confidence was used to determine the presence of IDs or aneurysms. For 3DRA with VR, the relationship between IDs and aneurysms was classified as one of the three types: type I, protrusion or bulge from side wall of IDs; type II, aneurysms involving or enclosing IDs; or type III, aneurysms and IDs coexisting near each other but with some distance between them.
The number of IDs found by 2DDSA and 3DRA with VR was 41 and 48, respectively. Five anterior choroidal arteries and two posterior communicating arteries IDs were missed by 2DDSA. According to 3DRA with VR, there were five IDs of type I, nine of type II, and 22 of type III.
The 3DRA with VR appears superior to 2DRA for both diagnosing IDs and displaying the anatomical relationship between IDs and aneurysms. The findings also suggest that some IDs might progress to aneurysms or become a part of them, which should be carefully evaluated prior to operation.
漏斗部扩张（ID）是一种解剖变异还是动脉瘤前体尚未明确确定。本研究的目的是通过使用容积再现（VR）的三维旋转血管造影（3DRA）来评估ID的解剖学变化。
138例已知或疑似动脉瘤的患者连续接受二维数字减影血管造影（2DDSA）和带VR的3DRA检查。两名阅片者根据相同的诊断标准，使用2DDSA和3DRA对ID或动脉瘤进行盲法评估。采用5分制观察者信心量表来确定ID或动脉瘤的存在。对于带VR的3DRA，ID与动脉瘤之间的关系分为三种类型之一：I型，ID侧壁的突出或膨出；II型，累及或包绕ID的动脉瘤；或III型，动脉瘤和ID彼此相邻但有一定距离并存。
2DDSA和带VR的3DRA发现的ID数量分别为41个和48个。2DDSA漏诊了5条脉络膜前动脉和2条后交通动脉的ID。根据带VR的3DRA，有5个I型ID、9个II型ID和22个III型ID。
带VR的3DRA在诊断ID和显示ID与动脉瘤之间的解剖关系方面似乎优于2DRA。研究结果还表明，一些ID可能进展为动脉瘤或成为动脉瘤的一部分，在手术前应仔细评估。
