Tanaka Riki, Liew Boon Seng, Yamada Yasuhiro, Sasaki Kento, Miyatani Kyosuke, Komatsu Fuminari, Kawase Tsukasa, Kato Yoko, Hirose Yuichi
Department of Neurosurgery, Fujita Health University Bantane Hospital, Nagoya, Aichi, Japan.
Asian J Neurosurg. 2022 Jun 13;17(1):43-49. doi: 10.1055/s-0042-1749148. eCollection 2022 Mar.
Preoperative illustration is a part of an important exercise to study the configuration, direction, and presence of any perforations, and is the weakest point in the wall of the cerebral aneurysm. The same illustration is used to study the surrounding brain structures to decide the best and safe surgical approach prior to any surgical procedure. With the evolution of the aneurysm wall study and study of flow dynamic within the involved artery and its aneurysm wall using computational fluid dynamics (CFD), a better surgical plan can be formulated to improve the flow dynamics. As one of the clinical applications of CFD, we propose a study using a composite image that combines preoperative illustration and CFD, which is traditionally widely used in neurosurgery. We study the use of illustrations of the unruptured cerebral aneurysm of internal carotid-posterior communicating (ICPC) artery and anterior communicating artery (AcomA) treated at our hospital. The combinations of both preoperative illustrations and CFD images by using "ipad Pro" were used. Medical illustration in the preoperative study of unruptured cerebral aneurysm with combinations of CFD and surrounding brain structures is helpful to decide the surgical approaches and successful surgical treatments.
术前造影是研究脑动脉瘤壁的形态、走向以及有无穿孔等重要操作的一部分，也是脑动脉瘤壁最薄弱的环节。同样，术前造影用于研究周围脑结构，以便在任何手术操作前确定最佳且安全的手术入路。随着动脉瘤壁研究以及利用计算流体动力学（CFD）对受累动脉及其动脉瘤壁内血流动力学的研究不断发展，可以制定出更好的手术方案来改善血流动力学。作为CFD的临床应用之一，我们提出一项使用复合图像的研究，该复合图像结合了术前造影和CFD，而术前造影在神经外科中传统上广泛使用。我们研究了我院治疗的颈内动脉-后交通动脉（ICPC）和前交通动脉（AcomA）未破裂脑动脉瘤的造影图像的使用情况。通过使用“iPad Pro”将术前造影图像和CFD图像进行了组合。在未破裂脑动脉瘤的术前研究中，将CFD与周围脑结构相结合的医学造影有助于确定手术入路并实现成功的手术治疗。
