Canon Stroke and Vascular Research Center, UB Neurosurgery, University at Buffalo, State University of New York, Buffalo, New York, USA.
Department of Neurosurgery, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, New York, United States.
J Neurointerv Surg. 2020 Sep;12(9):897-901. doi: 10.1136/neurintsurg-2019-015551. Epub 2020 Feb 11.
A new dual resolution imaging x-ray detector system (Canon Medical Systems Corporation, Tochigi, Japan) has a standard resolution 194 µm pixel conventional flat-panel detector (FPD) mode and a high-resolution 76 µm high-definition (Hi-Def) mode in a single unit. The Hi-Def mode enhances the visualization of the intravascular devices.
We report the clinical experience and physician evaluation of this new detector system with Hi-Def mode for the treatment of intracranial aneurysms using a Pipeline embolization device (PED).
During intervention at our institute, under large field of view (FOV) regular resolution FPD mode imaging, the catheter systems and devices were first guided to the proximity of the treatment area. Final placement and deployment of the PED was performed under Hi-Def mode guidance. A post-procedure 9-question physician survey was conducted to qualitatively assess the impact of Hi-Def mode visualization on physicians' intraoperative decision-making. One-sample t-test was performed on the responses from the survey. Dose values reported by the x-ray unit were also recorded.
Twenty-five cases were included in our study. The survey results indicated that, for each of the nine questions, the physicians in all cases indicated that the Hi-Def mode improved visualization compared with the FPD mode. For the 25 cases, the mean cumulative entrance air kerma was 2.35 Gy, the mean dose area product (DAP) was 173.71 Gy.cm, and the mean x-ray exposure time was 39.30 min.
The Hi-Def mode improves visualization of flow diverters and may help in achieving more accurate placement and deployment of devices.
一种新型的双分辨率成像 X 射线探测器系统（佳能医疗系统公司，日本栃木县）在单个单元中具有标准分辨率 194µm 像素的常规平板探测器（FPD）模式和高分辨率 76µm 的高清（Hi-Def）模式。Hi-Def 模式增强了血管内器械的可视化效果。
我们报告了使用新型探测器系统的 Hi-Def 模式治疗颅内动脉瘤的临床经验和医生评估，该系统使用 Pipeline 栓塞装置（PED）。
在我们的研究所进行介入治疗时，在大视野（FOV）常规分辨率 FPD 模式成像下，首先将导管系统和器械引导至治疗区域附近。在 Hi-Def 模式引导下进行最终 PED 放置和部署。在手术后进行了一项 9 个问题的医生调查，以定性评估 Hi-Def 模式可视化对医生术中决策的影响。对调查中的回答进行了单样本 t 检验。还记录了 X 射线设备报告的剂量值。
本研究共纳入 25 例患者。调查结果表明，对于九个问题中的每一个，所有病例的医生都表示 Hi-Def 模式比 FPD 模式改善了可视化效果。对于 25 例患者，平均累积入口空气比释动能为 2.35Gy，平均剂量面积乘积（DAP）为 173.71Gy.cm，平均 X 射线照射时间为 39.30 分钟。
Hi-Def 模式改善了血流导向器的可视化效果，可能有助于更准确地放置和部署器械。
