Mokin Maxim, Levy Elad I, Snyder Kenneth V, Siddiqui Adnan H
Department of Neurosurgery and Toshiba Stroke and Vascular Research Center, University at Buffalo, State University of New York, Buffalo, NY.
Department of Neurosurgery, Gates Vascular Institute, Kaleida Health, Buffalo, NY.
J Neuroimaging. 2014 Nov-Dec;24(6):543-547. doi: 10.1111/jon.12123. Epub 2014 Apr 9.
Early recognition of complications during intracranial neuroendovascular interventions is important for medical decision making and prompts administration of life-saving treatments. Low contrast imaging (LCI) provides computed tomographic (CT)-like images of anatomical brain structures, capable of detecting hydrocephalus and intracranial hemorrhage complications. We present our early experience with LCI using the Toshiba Infinix-i biplane angiographic suite during neurointerventional cases, including acute stroke interventions, aneurysm embolization, and subarachnoid hemorrhage management.
Six patients underwent LCI during various neuroendovascular procedures. We describe clinical and imaging findings and provide visual comparison of LCI with conventional noncontrast cranial CT imaging.
Our initial experience shows that LCI is capable of detecting or excluding intracerebral hemorrhage and hydrocephalus during neurointerventional procedures as well as confirming ventriculostomy catheter placement when compared to noncontrast CT imaging. Motion artifact is a major limitation associated with this technology and can be overcome in part by performing shorter duration rotation sequences.
LCI is a promising tool in the arsenal of a neuroendovascular interventionist, especially when a complication is suspected during an intervention, potentially obviating the need for immediate transfer of the patient to a conventional CT scanner. Further studies comparing LCI with conventional noncontrast CT imaging are necessary.
在颅内神经血管介入治疗过程中尽早识别并发症，对于医疗决策以及启动挽救生命的治疗措施至关重要。低对比度成像（LCI）可提供类似计算机断层扫描（CT）的脑部解剖结构图像，能够检测脑积水和颅内出血并发症。我们介绍了在神经介入病例中使用东芝Infinix-i双平面血管造影套件进行LCI的早期经验，包括急性卒中干预、动脉瘤栓塞和蛛网膜下腔出血管理。
6例患者在各种神经血管介入手术中接受了LCI。我们描述了临床和影像学发现，并提供了LCI与传统非增强头颅CT成像的视觉比较。
我们的初步经验表明，与非增强CT成像相比，LCI能够在神经介入手术期间检测或排除脑出血和脑积水，以及确认脑室造瘘管的放置位置。运动伪像是与该技术相关的主要限制因素，通过执行更短时长的旋转序列可部分克服这一问题。
LCI是神经血管介入医生的一项有前景的工具，尤其是在介入过程中怀疑有并发症时，可能无需立即将患者转运至传统CT扫描仪处。有必要开展进一步研究，将LCI与传统非增强CT成像进行比较。
