Zhang Q J, Kobayashi S, Toriyama T, Kyoshima K, Hongo K, Kuroyanagi T
Department of Neurosurgery, Shinshu University School of Medicine, Matsumoto, Japan.
Neurosurg Rev. 1993;16(4):283-9. doi: 10.1007/BF00383837.
Although it appears that carotid cave and ventral paraclinoid carotid aneurysms are different types of internal carotid artery (ICA) aneurysms, it can be difficult to differentiate the two on the basis of angiograms, because their locations are very close. The purpose of this study was to review the angiographic findings in 21 cases with carotid cave aneurysms and 7 cases with ventral paraclinoid carotid aneurysms of less than 15 mm in diameter (Nutik aneurysm) operated upon in our unit during the last 14 years, and to discuss the difference between the two groups. The results showed that in the anteroposterior view of the angiogram, all carotid cave aneurysms projected medially in semicircular, or berry shape, while only slight medial projection was noted in 3 cases with Nutik aneurysm, the remainder being superimposed on the ICA. In the lateral view of the angiogram, we found that in 6 of the 7 Nutik aneurysms there was a space between the axilla (area inside the genu of the ICA) and the anterior or anteroinferior wall of the aneurysm. This space was absent in all carotid cave aneurysms since these aneurysms projected inferoposteriorly from the genu of the ICA. It is concluded that predominant medial projection in the anteroposterior view and absence of space in the lateral view are two characteristic features of carotid cave aneurysms which can be used to differentiate them from most Nutik aneurysms.
尽管颈动脉管隐窝动脉瘤和海绵窦旁腹侧颈内动脉瘤似乎是颈内动脉（ICA）动脉瘤的不同类型，但基于血管造影很难区分两者，因为它们的位置非常接近。本研究的目的是回顾过去14年在我们科室接受手术的21例颈动脉管隐窝动脉瘤和7例直径小于15mm的海绵窦旁腹侧颈内动脉瘤（努蒂克动脉瘤）的血管造影结果，并探讨两组之间的差异。结果显示，在血管造影的前后位片上，所有颈动脉管隐窝动脉瘤呈半圆形或浆果形向内侧突出，而7例努蒂克动脉瘤中只有3例有轻微的向内侧突出，其余的与颈内动脉重叠。在血管造影的侧位片上，我们发现7例努蒂克动脉瘤中有6例在颈内动脉膝部内侧（ICA膝部内区域）与动脉瘤的前壁或前下壁之间存在间隙。所有颈动脉管隐窝动脉瘤均无此间隙，因为这些动脉瘤从颈内动脉膝部向后下突出。结论是，前后位片上主要向内侧突出和侧位片上无间隙是颈动脉管隐窝动脉瘤的两个特征，可用于将其与大多数努蒂克动脉瘤区分开来。
