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在多重动脉瘤的情况下识别破裂动脉瘤的挑战:利用MRI与对比度进行手术规划-一个病例报告

Ehsan Mohammad Hosseini¹, Saber Zafarshamspour^1,2, Oday Atallah³

¹Department of Neurosurgery Shiraz University of Medical Sciences Shiraz Fars Iran.

Clinical case reports

|July 26, 2024

概括

在患有多重动脉瘤和下关节出血 (SAH) 的患者中,识别破裂动脉瘤至关重要. 用对比的血管壁MRI有效地帮助确定出血源,指导治疗决策以获得更好的患者结果.

科学领域:

神经外科神经外科
神经辐射学神经辐射学
血管神经学血管神经学

背景情况:

多重内动脉瘤存在于大约20%的副arachnoid出血 (SAH) 病例中.
准确识别破裂动脉瘤对于防止再出血和优化患者的治疗结果至关重要.
在多个动脉瘤中区分出血源可能是标准神经成像的挑战.

研究的目的:

评估对比度增强的血管壁MRI在多重内动脉瘤和SAH患者中识别破裂动脉瘤的实用性.
为了证明血管壁MRI对复杂动脉瘤病例的临床决策和治疗计划的影响.

主要方法:

这里介绍了一个65岁女性的病例报告,她患有SAH和多重动脉瘤 (PICA和ACOM).
使用对比增强磁共振成像 (MRI) 可视化动脉瘤壁增强.
诊断数字减去血管造影 (DSA) 进行了进一步评估.

主要成果:

常规的神经成像无法清楚地识别破裂的动脉瘤.
与对比度增强的血管壁MRI显示了PICA动脉瘤的外围增强,表明它是出血源.
这一发现引导了转向微手术切割的转变,导致成功的单次治疗没有术后缺陷.

结论:

与对比度增强的血管壁MRI是识别破裂动脉瘤的宝贵工具,在复杂的SAH多重内动脉瘤复杂的情况下.
这种技术有助于量身定制治疗策略,可能改善治疗结果.
结合先进的成像和外科专业知识的多学科方法是有效的管理这些具有挑战性的病例.

关键词:

动脉瘤下arachnoid出血动脉瘤下arachnoid出血动脉瘤下arachnoid出血多重的内动脉瘤多重的内动脉瘤一个破裂的动脉瘤.血管壁的磁力共振成像

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