Choi Jai Ho, Shin Yong Sam, Kim Bum-Soo
Department of Neurosurgery, Seoul St Mary's Hospital, The Catholic University of Korea College of Medicine, Seoul, Korea.
Department of Radiology, Seoul St Mary's Hospital, The Catholic University of Korea College of Medicine, Seoul, Korea.
J Cerebrovasc Endovasc Neurosurg. 2023 Sep;25(3):253-259. doi: 10.7461/jcen.2023.E2022.10.002. Epub 2023 May 16.
Precise evaluation of the feeders, fistulous points, and draining veins plays a key role for successful embolization of intracranial dural arteriovenous fistulas (DAVF). Digital subtraction angiography (DSA) is a gold standard diagnostic tool to assess the exact angioarchitecture of DAVFs. With the advent of new image postprocessing techniques, we lately have been able to apply image fusion techniques with two different image sets obtained with flat panel detector rotational angiography. This new technique can provide additional and better pretherapeutic information of DAVFs over the conventional 2D and 3D angiographies. In addition, it can be used during the endovascular treatment to help the accurate and precise navigation of the microcatheter and microguidwire inside the vessels and identify the proper location of microcatheter in the targeted shunting pouch. In this study, we briefly review the process of an image fusion technique and introduce our clinical application for treating DAVFs, especially focused on the transvenous embolization.
精确评估供血动脉、瘘口及引流静脉对颅内硬脑膜动静脉瘘（DAVF）栓塞治疗的成功起着关键作用。数字减影血管造影（DSA）是评估DAVF确切血管结构的金标准诊断工具。随着新的图像后处理技术的出现，我们最近能够将平板探测器旋转血管造影获得的两组不同图像集应用于图像融合技术。这项新技术相较于传统的二维和三维血管造影，能够提供更多且更好的DAVF治疗前信息。此外，它可在血管内治疗过程中用于帮助微导管和微导丝在血管内准确精确地导航，并确定微导管在目标分流囊袋中的正确位置。在本研究中，我们简要回顾图像融合技术的过程，并介绍我们治疗DAVF的临床应用，尤其侧重于经静脉栓塞治疗。
