Zhu François, Bracard Serge, Trousset Yves, Anxionnat René
Department of Diagnostic and Interventional Neuroradiology, CHRU Nancy, Nancy, France.
IADI, INSERM U1254, Université de Lorraine, Nancy, France.
Interv Neuroradiol. 2023 Aug 1:15910199231193469. doi: 10.1177/15910199231193469.
Endovascular management of spinal dural arteriovenous fistula (DAVF) is arduous because of complex angioarchitecture and motion artifacts and is limited by the two-dimensional (2D) view. However, cone beam computed tomography (CBCT) acquisitions with selective injections allow 3D multiplanar reconstructions contributing to high diagnostic, anatomical and safety value. In this study, we described the use of virtual injection software (VIS) computed from CBCT acquisition and already used for prostatic and cerebral embolization, for the endovascular management of spinal DAVFs (EmboAssist, GE HealthCare, Chicago, USA). The VIS has been designed to facilitate the analysis of the patient's vasculature during the planning of embolization procedures to define the afferent pedicles to the shunt and the incidence of oblique projection, allowing for a better anatomical understanding and helping for the selection of 2D incidence. Combined with 3D roadmapping, VIS allows vessel tracking for selective catheterism and embolization. The VIS is a useful tool for planification and navigation during endovascular treatment of spinal DAVF with a safety value.
由于血管结构复杂和运动伪影，脊髓硬脊膜动静脉瘘（DAVF）的血管内治疗具有挑战性，并且受到二维（2D）视野的限制。然而，通过选择性注射进行的锥束计算机断层扫描（CBCT）采集可实现三维多平面重建，具有较高的诊断、解剖和安全价值。在本研究中，我们描述了使用从CBCT采集中计算出的虚拟注射软件（VIS），该软件已用于前列腺和脑栓塞，用于脊髓DAVF的血管内治疗（EmboAssist，GE医疗保健公司，美国芝加哥）。VIS旨在在栓塞手术规划期间促进对患者血管系统的分析，以确定分流的传入蒂和斜位投影的发生率，从而更好地理解解剖结构并有助于选择二维投照角度。结合三维路图，VIS可实现血管追踪，用于选择性插管和栓塞。VIS是脊髓DAVF血管内治疗规划和导航的有用工具，具有安全价值。
