Nagasawa S, Ohta T, Tsuda E
Department of Neurosurgery, Osaka Medical College, Takatsuki, Japan.
Surg Neurol. 1998 Mar;49(3):309-15. doi: 10.1016/s0090-3019(96)00372-2.
This study evaluated the usefulness of magnetic resonance (MR) angiography on preoperative depiction of surgical topography around anterior communicating artery aneurysms.
Twenty cases of anterior communicating artery aneurysms, nine ruptured and 11 unruptured, were included. MR angiographic source images and projection images were obtained by three-dimensional (3D) time-of-flight techniques. Conventional angiography was performed by femoral artery catheterization. By comparing the topography based on these angiograms to that confirmed during surgery, we evaluated the information provided by MR angiography that was beneficial during surgery.
MR angiographic source images could visualize cerebral and nerve tissues around the aneurysms in all 20 cases. In five cases, the source images provided additional useful information to that from conventional angiography. It included visualization of aneurysmal domes in the gyrus rectus in two cases and aneurysmal adhesion to the optic nerve or chiasma in three cases. These findings were considered to have contributed to successful aneurysmal surgery. The remaining 15 cases, however, had such typ ical anatomy around the aneurysm that clipping was conventionally performed without additional information from the source images.
MR angiographic source images have a distinguishing feature in defining neural tissue-vascular relationships and can significantly improve preoperative depiction of surgical topography. They would be useful only when there are still questions after careful reading of conventional angiography.
本研究评估了磁共振（MR）血管造影术在术前描绘前交通动脉动脉瘤周围手术解剖结构的实用性。
纳入20例前交通动脉动脉瘤患者，其中9例破裂，11例未破裂。采用三维（3D）时间飞跃技术获取MR血管造影源图像和投影图像。通过股动脉插管进行传统血管造影。通过将基于这些血管造影的解剖结构与手术中确认的解剖结构进行比较，我们评估了MR血管造影在手术中提供的有益信息。
20例患者的MR血管造影源图像均能显示动脉瘤周围的脑和神经组织。5例中，源图像提供了比传统血管造影更多的有用信息。其中2例显示了直回中动脉瘤的瘤顶，3例显示了动脉瘤与视神经或视交叉的粘连。这些发现被认为有助于动脉瘤手术的成功。然而，其余15例患者动脉瘤周围的解剖结构较为典型，传统上在没有源图像额外信息的情况下进行夹闭手术。
MR血管造影源图像在定义神经组织与血管关系方面具有显著特征，可显著改善术前手术解剖结构的描绘。只有在仔细阅读传统血管造影后仍有疑问时，它们才会有用。
