Meijs Midas, de Leeuw Frank-Erik, Boogaarts Hieronymus D, Manniesing Rashindra, Meijer Frederick Jan Anton
Department of Radiology, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands.
Department of Radiology, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands.
World Neurosurg. 2018 Jun;114:421-426.e1. doi: 10.1016/j.wneu.2018.02.189. Epub 2018 Mar 9.
In case of carotid artery occlusion, the risk and extent of ischemic cerebral damage are highly dependent on the pathways of collateral flow including the anatomy of the circle of Willis. In this report, cases are presented to illustrate that 4-dimensional computed tomography angiography (4D-CTA) can be considered as a noninvasive alternative to digital subtraction angiography for the evaluation of circle of Willis collateral flow.
Five patients with unilateral internal carotid artery (ICA) occlusion underwent 4D-CTA for the evaluation of intracranial hemodynamics. Next to a visual evaluation of 4D-CTA, temporal information was visualized using a normalized color scale on the cerebral vasculature, which enabled quantification of the contrast bolus arrival time. In these patients, 4D-CTA demonstrated dominant middle cerebral artery blood supply on the side of ICA occlusion originating from either the contralateral ICA or posterior circulation via the communicating arteries.
Temporal dynamics of collateral flow in the circle of Willis can be depicted with 4D-CTA in patients with a unilateral carotid artery occlusion.
在颈动脉闭塞的情况下，缺血性脑损伤的风险和程度高度依赖于侧支血流途径，包括Willis环的解剖结构。在本报告中，通过病例展示了四维计算机断层血管造影（4D-CTA）可被视为一种用于评估Willis环侧支血流的无创性替代数字减影血管造影的方法。
5例单侧颈内动脉（ICA）闭塞患者接受了4D-CTA检查以评估颅内血流动力学。除了对4D-CTA进行视觉评估外，还使用脑血管系统上的归一化色标对时间信息进行可视化，从而能够量化对比剂团注到达时间。在这些患者中，4D-CTA显示在ICA闭塞侧存在主要由对侧ICA或通过交通动脉的后循环供血的大脑中动脉供血。
对于单侧颈动脉闭塞患者，4D-CTA可以描绘Willis环侧支血流的时间动态。
