Preoperative novel magnetic resonance fusion imaging for carotid endarterectomy patients with contrast contraindications: a pilot study
Preoperative novel magnetic resonance fusion imaging for carotid endarterectomy patients with contrast contraindications: a pilot study
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具有对比禁忌症的颈动脉内膜切除术患者术前新型磁共振融合成像：一项试点研究
DOI：
10.1016/j.wneu.2023.04.071
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发表时间：
2023
期刊：
影响因子：
2
通讯作者：
Motohiro Morioka
中科院分区：
文献类型：
--
作者：
Jin Kikuchi;Hideo Arai;Ryo Doi ;Yasuharu Takeuchi;Ryoji Iwamoto;Hiroshi Nishimura;Motohiro Morioka
目的针对颈动脉内膜切除术（CEA）中肾功能不全且对造影剂过敏的患者，我们开发了一种新的术前非造影剂三维磁共振融合成像（NC-3DMRFI）方法，该方法即使在手术位置也能很好地描述血管、斑块和骨结构。在这项研究中，我们检验了这种方法的有效性。方法提取骨骼、血管和斑块的非对比磁共振图像，形成三维（3D）融合图像。在CEA期间，使用正常位置的图像和手术位置的图像创建融合图像。我们将融合成像结果与6例接受CEA的对比禁忌症患者的术中表现进行了比较。结果6例患者中5例术前NC-3DMRFI均能清晰显示颈动脉分叉位置、斑块远端及骨结构。术中发现和术前融合成像结果在所有可以创建融合图像的病例中是相似的。CEA术位融合成像有助于术前检查，高颈椎位置的手术空间可以得到保证。结论我们的NC-3DMRFI方法可用于CEA术前模拟，特别是对肾功能不全和造影剂过敏的患者。
ObjectiveFor carotid endarterectomy (CEA) patients with renal dysfunction and allergies to contrast media, we developed a preoperative novel method of non-contrast three-dimensional magnetic resonance fusion imaging (NC-3DMRFI) which could describe well blood vessels, plaques, and bony structures even in surgical position. In this study, we examined the usefulness of this method.MethodsWe extracted non-contrast magnetic resonance images of bones, blood vessels, and plaques to create a three-dimensional (3D) fusion image. An image acquired in the normal position and another in the surgical position during CEA were used to create a fusion image. We compared the fusion imaging results with the intraoperative findings of six patients with contrast contraindications received CEA.ResultsPreoperative NC-3DMRFI could clearly show the positions of the carotid bifurcation, the distal end of plaque, and the bony structure in five of the six cases. Intraoperative findings and preoperative fusion imaging results were comparable in all cases where fusion images could be created. The fusion imaging in the surgical position during CEA was useful for preoperative examination, and the surgical space could be secured in the case of a high cervical location.ConclusionThis pilot study showed our novel NC-3DMRFI method is useful for preoperative simulation in CEA, especially in patients with renal dysfunction and allergies to contrast media.