Kadooka Keisuke, Tanaka Michihiro, Sakata Yoshinori, Ideguchi Minoru, Inaba Maki, Hadeishi Hiromu
Department of Neurosurgery, Kameda Medical Center, Chiba, Japan.
Department of Neurosurgery, Kameda Medical Center, Chiba, Japan.
World Neurosurg. 2018 Jan;109:328-332. doi: 10.1016/j.wneu.2017.10.026. Epub 2017 Oct 16.
Exact identification of feeding arteries, shunt points, and draining veins is essential in treating cavernous sinus dural arteriovenous fistula (CS dAVF). In addition to digital subtraction angiography (DSA) and 3-dimensional rotational angiography (3DRA), high-resolution cone beam computed tomography (CBCT; especially 80-kv high-resolution cone beam computed tomography) have been performed in recent years. We evaluated the efficacy of CBCT in treating CS dAVF.
Eight CS dAVFs were treated with endovascular embolization between January 2013 and December 2016. We retrospectively examined these cases regarding information from DSA, 3DRA, and CBCT with contrast medium.
Although all procedures can evaluate feeding arteries, shunt points, and draining veins, CBCT can provide the best definition of feeders and their course through the bony structures and the compartment of CS. Therefore, CBCT with placed microcatheter in the CS can reveal whether the microcatheter is set at the appropriate compartment to be embolized.
The efficacy of CBCT in treating dAVF is illustrating the relationships among the bony structures and feeders, compartment of CS, and the position of the microcatheter. Detailed information obtained with CBCT can lead to fewer complications and more effective treatment.
准确识别供血动脉、分流点和引流静脉对于治疗海绵窦硬脑膜动静脉瘘（CS dAVF）至关重要。除数字减影血管造影（DSA）和三维旋转血管造影（3DRA）外，近年来还开展了高分辨率锥形束计算机断层扫描（CBCT；尤其是80千伏高分辨率锥形束计算机断层扫描）。我们评估了CBCT在治疗CS dAVF中的疗效。
2013年1月至2016年12月期间，对8例CS dAVF患者进行了血管内栓塞治疗。我们回顾性研究了这些病例的DSA、3DRA和含造影剂的CBCT信息。
虽然所有检查方法都能评估供血动脉、分流点和引流静脉，但CBCT能最清晰地显示供血动脉及其通过骨质结构和海绵窦腔隙的走行。因此，将微导管置于海绵窦内的CBCT能够显示微导管是否置于合适的待栓塞腔隙。
CBCT在治疗dAVF中的作用在于阐明骨质结构与供血动脉、海绵窦腔隙及微导管位置之间的关系。通过CBCT获得的详细信息可减少并发症并提高治疗效果。
