Matsukawa So, Ishii Akira, Fushimi Yasutaka, Abekura Yu, Nagahori Takashi, Kikuchi Takayuki, Okawa Masakazu, Yamao Yukihiro, Sasaki Natsuhi, Tsuji Hirofumi, Akiyama Ryo, Miyamoto Susumu
Departments of1Neurosurgery and.
2Diagnostic Imaging and Nuclear Medicine, Kyoto University Graduate School of Medicine, Faculty of Medicine, Kyoto, Japan.
J Neurosurg Case Lessons. 2023 Oct 2;6(14). doi: 10.3171/CASE23307.
The effect of vessel wall magnetic resonance imaging (VW-MRI) enhancement in partially thrombosed aneurysms has previously indicated aneurysmal instability and a rupture risk. However, whether the contrast effect of the wall changes before or after flow diversion treatment is still under investigation.
The authors report a case of a partially thrombosed basilar artery aneurysm that increased in size over a short period, worsened brainstem compression symptoms, and was treated with a flow diverter stent with good results. In this case, VW-MRI after surgery showed a reduced contrast effect on the intraluminal thrombus within the aneurysm. The aneurysm thrombosed and markedly regressed over the next 5 months, with remarkable improvement in the brainstem compression symptoms.
This finding on VW-MRI may indicate an attenuation of neovascularization in the thrombus wall and be a sign of aneurysm stabilization.
血管壁磁共振成像（VW-MRI）增强在部分血栓形成的动脉瘤中的作用先前已表明动脉瘤不稳定和破裂风险。然而，血流导向治疗前后血管壁的对比效果是否发生变化仍在研究中。
作者报告了一例部分血栓形成的基底动脉动脉瘤病例，该动脉瘤在短时间内增大，脑干压迫症状加重，接受了血流导向支架治疗，效果良好。在该病例中，术后VW-MRI显示动脉瘤腔内血栓的对比效果降低。在接下来的5个月里，动脉瘤血栓形成并明显缩小，脑干压迫症状显著改善。
VW-MRI上的这一发现可能表明血栓壁新生血管形成减弱，是动脉瘤稳定的标志。
