Derdeyn C P, Graves V B, Turski P A, Masaryk A M, Strother C M
Department of Radiology, University of Wisconsin Hospitals and Clinics, Madison, USA.
AJNR Am J Neuroradiol. 1997 Feb;18(2):279-86.
To review our experience using MR angiography to assess the cerebral vasculature after aneurysmal treatment with Guglielmi detachable coils (GDCs).
Forty three-dimensional time-of-flight MR angiographic studies were performed in 23 patients after endovascular aneurysmal therapy with GDCs. Digital subtraction angiographic (DSA) studies were evaluated retrospectively for the following findings: parent artery patency, branch vessel patency, residual flow within the aneurysm, and residual aneurysmal neck. The MR angiographic examinations were inspected for the same findings, as well as for the degree of signal loss surrounding the coil mass. Clinical histories were reviewed to determine the impact of MR angiographic findings on therapy.
Patency status of the parent artery was correctly identified on 25 of 26 MR angiographic examinations with DSA confirmation. Thirty-four of 37 patent branch vessels were identified by MR angiography. Residual neck was correctly identified in seven studies of six aneurysms, with no false-negative or false-positive results. Intraaneurysmal flow was correctly identified in five of eight studies of six aneurysms with residual flow shown by DSA. Artifact and hemorrhage mimicked residual flow in two of 18 MR angiographic studies of aneurysms with no residual flow shown by DSA. In eight patients, MR angiography provided clinically useful information that affected therapy.
MR angiography can identify flow within an aneurysm after treatment with GDCs as well as in the adjacent parent and branch vessels. This technique may be a useful adjunct to DSA in some clinical situations.
回顾我们使用磁共振血管造影术评估使用 Guglielmi 可脱卸弹簧圈（GDC）治疗动脉瘤后脑血管系统的经验。
对 23 例接受 GDC 血管内动脉瘤治疗后的患者进行了 43 次三维时间飞跃磁共振血管造影研究。对数字减影血管造影（DSA）研究进行回顾性评估，以确定以下结果：载瘤动脉通畅情况、分支血管通畅情况、动脉瘤内残余血流以及残余动脉瘤颈。对磁共振血管造影检查进行相同结果的检查，以及线圈团块周围信号丢失的程度。回顾临床病史以确定磁共振血管造影结果对治疗的影响。
在 26 次经 DSA 证实的磁共振血管造影检查中，有 25 次正确识别了载瘤动脉的通畅状态。磁共振血管造影识别出了 37 条通畅分支血管中的 34 条。在对 6 个动脉瘤的 7 项研究中正确识别出了残余颈，无假阴性或假阳性结果。在 6 个动脉瘤的 8 项研究中，有 5 项通过磁共振血管造影正确识别出了动脉瘤内血流，DSA 显示有残余血流。在 18 项动脉瘤磁共振血管造影研究中，有 2 项显示无残余血流，但伪影和出血模拟了残余血流，而 DSA 未显示残余血流。在 8 例患者中，磁共振血管造影提供了影响治疗的临床有用信息。
磁共振血管造影可以识别 GDC 治疗后动脉瘤内以及相邻载瘤动脉和分支血管内的血流。在某些临床情况下，该技术可能是 DSA 的有用辅助手段。
