From the Department of Neurological Surgery (T.S.), Ryofukai Satoh Neurosurgical Hospital, Fukuyama, Hiroshima, Japan
Department of Neurological Surgery (T.H., M.H., K.S., I.D.), Okayama University Graduate School of Medicine, Okayama, Okayama, Japan.
AJNR Am J Neuroradiol. 2019 May;40(5):802-807. doi: 10.3174/ajnr.A6026. Epub 2019 Apr 4.
Our aim was to visualize the precise configuration of the aneurysmal neck and dome with/without remnants combined with a coiled dome after coiling treatment for cerebral aneurysms. We developed 3D multifusion imaging of silent MRA and FSE-MR cisternography.
We examined 12 patients with 3D multifusion imaging by composing 3D images reconstructed from TOF-MRA, silent MRA, and FSE-MR cisternography. The influence of magnetic susceptibility artifacts caused by metal materials affecting the configuration of the aneurysmal complex with coiling was assessed in a single 3D image.
In all cases, TOF-MRA failed to depict the aneurysmal neck complex precisely due to metal artifacts, whereas silent MRA delineated the neck and parent arteries at the coiled regions without serious metal artifacts. FSE-MR cisternography depicted the shape of the coiled aneurysmal dome and parent artery complex together with the brain parenchyma. With the 3D multifusion images of silent MRA and FSE-MR cisternography, the morphologic status of the coiled neck and parent arteries was clearly visualized with the shape of the dome in a single 3D image.
Silent MRA is a non-contrast-enhanced form of MRA. It depicts the coiled neck complex without serious metal artifacts. FSE-MR cisternography can delineate the shape of the coiled dome. In this small feasibility study, 3D multifusion imaging of silent MRA and FSE-MR cisternography allowed good visualization of key features of coiled aneurysms. This technique may be useful in the follow-up of coiled aneurysms.
本研究旨在可视化颅内动脉瘤弹簧圈栓塞治疗后瘤颈和瘤顶残腔与瘤腔的精确形态。我们开发了一种基于静默 MRA 和 FSE-MR 脑池造影的 3D 多融合成像。
我们对 12 例患者进行了 3D 多融合成像检查，通过组合来自 TOF-MRA、静默 MRA 和 FSE-MR 脑池造影的 3D 图像来进行。评估了金属材料引起的磁敏感伪影对带有弹簧圈的动脉瘤复合体形态的影响。
在所有病例中，由于金属伪影的影响，TOF-MRA 均无法精确显示瘤颈复合体，而静默 MRA 则可以在没有严重金属伪影的情况下清晰显示瘤颈和载瘤动脉。FSE-MR 脑池造影可以一起显示弹簧圈动脉瘤瘤顶和载瘤动脉复合体的形态以及脑实质。通过静默 MRA 和 FSE-MR 脑池造影的 3D 多融合图像，可以在单个 3D 图像中清晰显示弹簧圈瘤颈和载瘤动脉的形态，以及瘤顶的形态。
静默 MRA 是一种无对比剂增强的 MRA 形式，它可以清晰显示无严重金属伪影的弹簧圈瘤颈复合体。FSE-MR 脑池造影可以显示弹簧圈瘤顶的形态。在这项小的可行性研究中，静默 MRA 和 FSE-MR 脑池造影的 3D 多融合成像可以很好地显示弹簧圈动脉瘤的关键特征。这种技术可能在弹簧圈动脉瘤的随访中具有应用价值。
