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新型主要可生物吸收的血流导向支架治疗动脉瘤的透视、CT 和 MR 成像特征。

Fluoroscopy, CT, and MR imaging characteristics of a novel primarily bioresorbable flow-diverting stent for aneurysms.

机构信息

Department of Clinical Neurosciences, 2129University of Calgary, Calgary, Alberta, Canada.

Fluid Biotech Inc., Calgary, Alberta, Canada.

出版信息

Interv Neuroradiol. 2022 Dec;28(6):660-667. doi: 10.1177/15910199211060979. Epub 2021 Nov 17.

Abstract

BACKGROUND

Five to ten percent of the global population have unruptured intracranial aneurysms, and ruptured brain aneurysms cause approximately 500,000 deaths a year. Flow-diverting stent treatment is a less invasive intracranial aneurysm treatment that induces aneurysm thrombosis. The imaging characteristics of a novel primarily bioresorbable flow-diverting stent (BFDS) are assessed in comparison to the leading metal stent using fluoroscopy, CT, and MRI.

METHODS

X-ray/fluoroscopic images of stents were taken using a human cadaveric skull model. CT and MRI were acquired using silicone flow models of residual aneurysms. Images were analyzed with Likert scales in anonymous surveys by neurointerventionalists. Quantitative measurements of radiographic density (CT) and artifact boundary size (CT & MRI) were also obtained.

RESULTS

Visibility of the BFDS on X-ray was less than the metal stent but deemed adequate for deployment and intraprocedural assessment. The metal stent was more radiopaque than the BFDS on CT, but qualitative assessment was not significantly different for the two stents. MRI imaging was significantly better using the BFDS in terms of overall artifact and intraluminal assessment.

CONCLUSIONS

The BFDS has adequate visualization on X-ray/fluoroscopy and should be clinically acceptable for fluoroscopic deployment. On MRI, there is less quantitative artifact as well as overall improved qualitative assessment that will allow for more detailed non-invasive imaging follow-up of treated aneurysms, potentially reducing the need for digital subtraction catheter angiography.

摘要

背景

全球人口中有 5%至 10%患有未破裂颅内动脉瘤,而破裂的脑动脉瘤每年导致约 50 万人死亡。血流导向支架治疗是一种较微创的颅内动脉瘤治疗方法,可诱发动脉瘤血栓形成。与领先的金属支架相比,评估新型主要可生物吸收血流导向支架 (BFDS) 的影像学特征。

方法

使用人体头颅模型拍摄支架的 X 射线/荧光透视图像。使用残余动脉瘤的硅酮流动模型获取 CT 和 MRI。由神经介入医师匿名进行问卷调查,用李克特量表分析图像。还获得了放射密度(CT)和伪影边界大小(CT 和 MRI)的定量测量。

结果

BFDS 在 X 射线上的可见性低于金属支架,但足以进行部署和术中评估。在 CT 上,金属支架比 BFDS 更具放射性,但两种支架的定性评估没有显著差异。在总体伪影和管腔评估方面,MRI 成像使用 BFDS 明显更好。

结论

BFDS 在 X 射线/荧光透视下具有足够的可视化效果,对于荧光透视部署应具有临床可接受性。在 MRI 上,定量伪影较少,整体定性评估得到改善,这将允许对治疗后的动脉瘤进行更详细的非侵入性成像随访,可能减少对数字减影导管血管造影的需求。

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