Kuriyama Takumi, Sakai Nobuyuki, Niida Norimitsu, Sueoka Masaki, Beppu Mikiya, Dahmani Chihebeddine, Kojima Iwao, Sakai Chiaki, Imamura Hirotoshi, Masago Katsuhiro, Katakami Nobuyuki
Division of Radiological Technology, Institute of Biomedical Research and Innovation, Kobe, Japan
Division of Neuroendovascular Therapy, Institute of Biomedical Research and Innovation, Kobe, Japan Division of Neurosurgery, Kobe City Medical Center General Hospital, Kobe, Japan.
Interv Neuroradiol. 2016 Aug;22(4):420-5. doi: 10.1177/1591019916632489. Epub 2016 Feb 24.
Flat panel detector (FD)-equipped angiography machines are increasingly used for neuro-angiographic imaging. During intracranial stent-assisted coil embolization procedures, it is very important to clearly and quickly visualize stent shape after deployment in the vessel. It is necessary to quickly visualize stents by cone-beam computed tomography (CBCT). The aim of this study was to compare CBCTs at 10 and 20 s, and to confirm that this method is useful for neuro-endovascular treatment procedures.
We treated 30 patients with wide-necked intracranial aneurysms with a flexible, self-expanding neurovascular stent and subsequent aneurysm embolization with platinum micro-coils. We performed the CBCT after stent deployment. We compared the 10 s and 20 s CBCTs, using the full width one-half maximum (FWHM) visualization.
Accurate stent placement with subsequent coil occlusion of the aneurysms was feasible in all patients. Stent struts were clearly visualized on both 10 s and 20 s CBCTs. Importantly, 10 s CBCT can reduce the radiation dose by about 42%, compared with 20 s CBCT. Performing 10 s CBCT with a 14% dilution of the contrast medium may significantly improve image acquisition during stent-assisted coil embolization.
Reduced-dose, 10 s CBCT can visualize stents in clinical cases, while significantly reducing radiation exposure.
配备平板探测器（FD）的血管造影机越来越多地用于神经血管造影成像。在颅内支架辅助弹簧圈栓塞手术过程中，血管内支架展开后清晰快速地显示其形状非常重要。有必要通过锥形束计算机断层扫描（CBCT）快速显示支架。本研究的目的是比较10秒和20秒时的CBCT，并证实该方法对神经血管内治疗手术有用。
我们使用可弯曲的自膨式神经血管支架治疗30例宽颈颅内动脉瘤患者，随后用铂微弹簧圈栓塞动脉瘤。在支架展开后进行CBCT检查。我们使用半高全宽（FWHM）可视化比较了10秒和20秒时的CBCT。
所有患者均可行准确的支架置入及随后的动脉瘤弹簧圈栓塞。在10秒和20秒的CBCT上均能清晰显示支架支柱。重要的是，与20秒的CBCT相比，10秒的CBCT可使辐射剂量降低约42%。在支架辅助弹簧圈栓塞过程中，使用稀释14%的造影剂进行10秒的CBCT检查可能会显著改善图像采集。
降低剂量的10秒CBCT能够在临床病例中显示支架，同时显著减少辐射暴露。
