Katsuki Masahito, Narita Norio, Ozaki Dan, Sato Yoshimichi, Iwata Saki, Tominaga Teiji
Department of Neurosurgery, Kesennuma City Hospital, Kesennuma, Miyagi.
Department of Radiological Technology, Sapporo City General Hospital, Sapporo, Hokkaido, Japan.
Surg Neurol Int. 2020 Aug 1;11:224. doi: 10.25259/SNI_329_2020. eCollection 2020.
The assessment of the clipped cerebral aneurysm and the cerebral arteries after the treatment of subarachnoid hemorrhage (SAH) is important to find aneurysm regrowth or postoperative cerebral vasospasm. Usually, contrast-enhanced computed tomography angiography is performed for the evaluation of the arteries, but it has side effects of contrast medium. Time-of-flight magnetic resonance angiography (MRA) is a fast and non-invasive method, but clip-induced artifact limits assessment of the artery in the vicinity of the clip. 1.5T MRA with ultrashort echo time (UTE) reduces metal artifact, but the obtained image is too rough to evaluate the aneurysm remnant, and the description range is too narrow to assess the cerebral vasospasm. We routinely use SIGNA Pioneer 3.0T (GE Healthcare Life Sciences, Buckinghamshire, England) and perform SILENT SCAN with UTE-MRA for the postoperative assessment of the clipped aneurysm and cerebral arteries for SAH patients treated by clipping. It has better image quality and describes arteries with a wide description range, so it possesses the potential to overcome the disadvantages of 1.5T UTE-MRA.
We presented a representative SAH patient who postoperatively underwent 3.0T UTE- MRA after clipping. The artery near the clipped aneurysm was evaluated in detail, and the cerebral arteries were described from the main trunk to the peripheral parts with a wide description range, which enabled the assessment of cerebral vasospasm.
3.0T UTE-MRA may be helpful for the usual assessment of the arteries after clipping and cerebral vasospasm in the future.
蛛网膜下腔出血(SAH)治疗后对夹闭的脑动脉瘤和脑动脉进行评估,对于发现动脉瘤再生长或术后脑血管痉挛非常重要。通常,采用对比增强计算机断层血管造影来评估动脉,但存在造影剂副作用。时间飞跃磁共振血管造影(MRA)是一种快速且无创的方法,但夹子引起的伪影限制了对夹子附近动脉的评估。具有超短回波时间(UTE)的1.5T MRA可减少金属伪影,但获得的图像过于粗糙,无法评估动脉瘤残留,且描述范围过窄,无法评估脑血管痉挛。我们常规使用SIGNA Pioneer 3.0T(通用电气医疗生命科学公司,英国白金汉郡),并对接受夹闭治疗的SAH患者术后采用UTE-MRA进行SILENT SCAN,以评估夹闭的动脉瘤和脑动脉。其图像质量更好,描述动脉的范围更广泛,因此有潜力克服1.5T UTE-MRA的缺点。
我们展示了一名具有代表性的SAH患者,其术后接受了夹闭和3.0T UTE-MRA检查。对夹闭动脉瘤附近的动脉进行了详细评估,并从主干到外周部分广泛描述了脑动脉,从而能够评估脑血管痉挛。
3.0T UTE-MRA未来可能有助于夹闭术后动脉和脑血管痉挛的常规评估。