Coloring Technique of Magnetic Resonance Angiography for Superficial Temporal Artery to Middle Cerebral Artery Bypass Surgery
Coloring Technique of Magnetic Resonance Angiography for Superficial Temporal Artery to Middle Cerebral Artery Bypass Surgery
复制标题
颞浅动脉至大脑中动脉搭桥手术的磁共振血管造影彩色技术
DOI：
10.1016/j.wneu.2017.12.152
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发表时间：
2018
期刊：
影响因子：
--
通讯作者：
Saito Koji
中科院分区：
文献类型：
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作者：
Okazaki Toshiyuki;Irie Shinsuke;Inagaki Toru;Saito Osamu;Yamashina Motoshige;Hayase Hitoshi;Nakagawa Hiroshi;Nagahiro Shinji;Saito Koji
目的颞浅动脉(STA)至大脑中动脉(MCA)搭桥术是一种成熟的实现血运重建的外科技术。选择合适的MCA受体动脉是很重要的。三维CT血管造影术(3D-CTA)和常规血管造影术在选择过程中是有用的，但需要造影剂。作者设计了一种不需要试剂就能显示受体动脉的着色MRA技术。方法从2013年1月开始，对受区动脉选择、开颅手术部位和大小的选择进行回顾性评价。对92例颈内动脉(ICA)动脉粥样硬化性狭窄或闭塞患者行STA-MCA搭桥术，参照彩色MRA。为评价彩色MRA的效果，对照组为2012年1月至2013年11月在3D-CTA基础上行大脑中动脉搭桥术的患者75例。结果两组患者均未进行额外开颅手术，也未对受体动脉进行错误选择。结论彩色MRA技术在开颅手术的大小上不逊色于3D-CTA。这项新技术不仅对正确的受体动脉的虚拟识别非常有用，而且对于术前模拟，如决定供体动脉的长度、位置和开颅大小也是非常有帮助的。
ObjectiveSuperficial temporal artery (STA)–to–middle cerebral artery (MCA) bypass is an established surgical technique for achieving revascularization. It is important to select the proper recipient artery of the MCA. Three-dimensional computed tomographic angiography (3D-CTA) and conventional angiography are useful in the selection process but need contrast agents. The authors have designed a coloring MRA technique that needs no agents to visualize the recipient artery. Retrospective evaluation of the efficacy and limitation for selection of the recipient artery and decision of the place and size of the craniotomy were carried out.MethodsThe authors performed the coloring MRA before operation since January 2013. Ninety-two patients underwent STA-MCA bypass for atherosclerotic stenosis or occlusion of internal carotid artery (ICA), MCA with reference to the coloring MRA. To evaluate the efficacy of coloring MRA, the control group consisted of 75 patients who underwent STA-MCA bypass between January 2012 to November 2013 with reference to 3D-CTA. The size of craniotomy was retrospectively calculated and compared.ResultsNeither additional craniotomy nor wrong selection of the recipient artery was done in either group. There was no significant difference in size between the 2 groups in both single and double bypass.ConclusionsThe coloring MRA technique was not inferior to 3D-CTA with respect to the size of craniotomy. This novel technique was found to be very helpful not only for the virtual identification of the proper recipient artery but also for preoperative simulation such as decisions about length of donor artery, location, and size of craniotomy.