Efficacy of Utilizing Both 3-Dimensional Multimodal Fusion Image and Intra-Arterial Indocyanine Green Videoangiography in Cerebral Arteriovenous Malformation Surgery
Efficacy of Utilizing Both 3-Dimensional Multimodal Fusion Image and Intra-Arterial Indocyanine Green Videoangiography in Cerebral Arteriovenous Malformation Surgery
复制标题
三维多模态融合图像与动脉内吲哚菁绿视频血管造影在脑动静脉畸形手术中的疗效
DOI：
10.1016/j.wneu.2022.10.121
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发表时间：
2023
影响因子：
2
通讯作者：
Takagi Yasushi
中科院分区：
文献类型：
--
作者：
Shimada Kenji;Miyake Kazuhisa;Yamaguchi Izumi;Sogabe Shu;Korai Masaaki;Kanematsu Yasuhisa;Takagi Yasushi
目的了解动静脉畸形（AVM）的复杂形态对于成功切除很重要。我们之前曾报道过动脉内吲哚菁绿（ICG）视频血管造影术用于此目的，但该方法无法检测脑组织覆盖的血管结构。据报道，3 维 (3D) 多模态融合成像可用于同一目的，但由于源图像和处理技术较差，无法始终可视化精确的血管结构。本研究检验了两种技术在 AVM 患者中的应用结果。方法这两种技术均应用于 12 名 AVM 患者。将两张图像与手术视图进行比较并由外科医生进行评估。结果尽管在所有病例中通过 ICG 视频血管造影识别浅表供血血管的评估均较高，但 AVM 越复杂，通过 3D 多模态融合成像的评估越低。相反，在所有病例中，通过 3D 多模态融合成像对病灶估计范围的评估都较高，但除 1 例外，通过 ICG 视频血管造影对所有病例的评估均较低。 ICG 视频血管造影后获得的 Flow 800 分析可识别病灶流量减少。结论这些结果表明，在 AVM 手术中同时使用两种技术比单独使用每种技术更有用。这对于识别浅表饲养者和估计病巢范围特别有效。该技术有望为 AVM 手术提供最佳工具。
ObjectiveAn understanding of the complex morphology of an arteriovenous malformation (AVM) is important for successful resection. We have previously reported the utility of intra-arterial indocyanine green (ICG) videoangiography for this purpose, but that method cannot detect the angioarchitecture covered by brain tissue. 3-dimensional (3D) multimodal fusion imaging is reportedly useful for this same purpose, but cannot always visualize the exact angioarchitecture due to poor source images and processing techniques. This study examined the results of utilizing both techniques in patients with AVMs.MethodsBoth techniques were applied in 12 patients with AVMs. Both images were compared with surgical views and evaluated by surgeons.ResultsAlthough evaluations for identifying superficial feeders by ICG videoangiography were high in all cases, the more complicated the AVM, the lower the evaluation by 3D multimodal fusion imaging. Conversely, evaluation of the estimated range of the nidus was high in all cases by 3D multimodal fusion imaging, but low in all but one case by ICG videoangiography. Nidus flow reduction was recognized by Flow 800 analysis obtained after ICG videoangiography.ConclusionsThese results showed that utilizing both techniques together was more useful than each modality alone in AVM surgery. This was particularly effective in identifying superficial feeders and estimating the range of the nidus. This technique is expected to offer an optimal tool for AVM surgery.