Kobayashi Satoshi, Osanai Toshiya, Sugiyama Taku, Fujima Noriyuki, Takagi Ryo, Yokota Isao, Hamaguchi Akiyoshi, Nakamura Toshitaka, Hida Kazutoshi, Fujimura Miki
Department of Neurosurgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Hokkaido, Japan.
Department of Neurosurgery, Sapporo Azabu Neurosurgical Hospital, Sapporo, Hokkaido, Japan.
J Neuroendovasc Ther. 2023;17(6):120-124. doi: 10.5797/jnet.oa.2023-0001. Epub 2023 May 17.
In endovascular treatment, it is important to evaluate the access route for placing a catheter into the common carotid artery (CCA) promptly and safely prior to the procedure. We examined whether non-contrast MRA using time-spatial labeling inversion pulse (Time-SLIP) can be used in patients prior to endovascular thrombectomy for acute ischemic stroke. We compared Time-SLIP MRA to contrast-enhanced (CE) MRA and evaluated the efficacy in the evaluation of access routes.
We retrospectively reviewed 31 patients admitted between October 2018 and December 2018 for cerebral infarction at our hospital. Blood vessels were imaged from the aortic arch to the CCA. A radiologist blindly evaluated quality score, stenosis, shape of the aorta, and degree of tortuosity.
There were no "non-diagnostic" images. The sensitivity, specificity, positive predictive value, and negative predictive value for stenosis were 83%, 96%, 83%, and 96%, respectively. The sensitivity for the aorta type classification was 100%. The sensitivity for mild tortuosity was 93%, for moderate was 100%, and for severe was 100%.
Time-SLIP MRA can be an alternative to CE MRA in access route assessment for patients with cerebral infarction who are not eligible for acute thrombectomy therapy.
在血管内治疗中，在手术前迅速且安全地评估将导管置入颈总动脉（CCA）的入路至关重要。我们研究了使用时空标记反转脉冲（Time-SLIP）的非对比磁共振血管造影（MRA）是否可用于急性缺血性卒中血管内血栓切除术患者。我们将Time-SLIP MRA与对比增强（CE）MRA进行比较，并评估其在评估入路方面的有效性。
我们回顾性分析了2018年10月至2018年12月在我院因脑梗死入院的31例患者。对从主动脉弓到CCA的血管进行成像。一名放射科医生对质量评分、狭窄情况、主动脉形态和迂曲程度进行盲法评估。
无“非诊断性”图像。狭窄的敏感性、特异性、阳性预测值和阴性预测值分别为83%、96%、83%和96%。主动脉类型分类的敏感性为100%。轻度迂曲的敏感性为93%，中度为100%，重度为100%。
对于不符合急性血栓切除术治疗条件的脑梗死患者，Time-SLIP MRA可作为CE MRA在入路评估中的替代方法。
