Jo K I, Kim S R, Choi J H, Kim K H, Jeon P
Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 135-710, South Korea.
Neuroradiology. 2015 Nov;57(11):1121-6. doi: 10.1007/s00234-015-1570-0. Epub 2015 Aug 21.
Contrast-enhanced cone-beam computed tomography (CBCT) has been introduced and accepted as a useful technique to evaluate delicate vascular anatomy and neurovascular stents. Current protocol for CBCT requires quantitative dilution of contrast medium to obtain adequate quality images. Here, we introduce simple methods to obtain contrast-enhanced CBCT without quantitative contrast dilution.
A simple experiment was performed to estimate the change in flow rate in the internal carotid artery during the procedure. Transcranial doppler (TCD) was used to evaluate the velocity change before and after catheterization and fluid infusion. In addition, 0.3 cm(3)/s (n = 3) and 0.2 cm(3)/s (n = 7) contrast infusions were injected and followed by saline flushes using a 300 mmHg pressure bag to evaluate neurovascular stent and host arteries.
Flow velocities changed -15 ± 6.8 % and +17 ± 5.5 % from baseline during catheterization and guiding catheter flushing with a 300 mmHg pressure bag, respectively. Evaluation of the stents and vascular structure was feasible using this technique in all patients. Quality assessment showed that the 0.2 cm(3)/s contrast infusion protocol was better for evaluating the stent and host artery.
Contrast-enhanced CBCT can be performed without quantitative contrast dilution. Adequate contrast dilution can be achieved with a small saline flush and normal blood flow.
对比增强锥形束计算机断层扫描（CBCT）已被引入并被视为评估精细血管解剖结构和神经血管支架的有用技术。当前CBCT方案需要对造影剂进行定量稀释以获得足够质量的图像。在此，我们介绍无需定量造影剂稀释即可获得对比增强CBCT的简单方法。
进行了一项简单实验以估计该过程中颈内动脉血流速度的变化。使用经颅多普勒（TCD）评估插管和液体输注前后的速度变化。此外，注入0.3 cm³/s（n = 3）和0.2 cm³/s（n = 7）的造影剂输注，然后使用300 mmHg压力袋进行生理盐水冲洗，以评估神经血管支架和宿主动脉。
在插管和使用300 mmHg压力袋冲洗引导导管期间，血流速度分别比基线变化了-15±6.8%和+17±5.5%。使用该技术在所有患者中评估支架和血管结构都是可行的。质量评估表明，0.2 cm³/s造影剂输注方案在评估支架和宿主动脉方面更好。
无需对造影剂进行定量稀释即可进行对比增强CBCT。通过少量生理盐水冲洗和正常血流可实现足够的造影剂稀释。
