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cerebral angiography and MR perfusion images in patients with ischemic cerebral vascular disease

Chinese Medical Journal 2002年第11期115卷 1687-1691,153页

作者：朱明旺戴建平李少武北京市神经外科研究所神经影像室首都医科大学附属天坛医院神经放射科北京100050

OBJECTIVE: To evaluate the value of perfusion MR imaging and angiographic evidence of collateral circulation in symptomatic patients with ischemic cerebrovascular diseases (ICVD). METHODS: cerebral angiography and perfusion MR were performed in 16 patients with symptoms of ICVD. Qualitative perfusion maps were calculated for regional cerebral blood volume (rCBV) and mean transit time (MTT). RESULTS: A total of 27 lesions were seen on the perfusion MR maps (6 infarcts and 21 ischemic lesions) and most of them (26/27) showed a prolonged MTT. MTT is sensitive to the presence of ischemic lesions, but not sufficient in distinguishing infarct from ischemia. All of the infarcts showed a decreased rCBV, while most of the ischemic lesions showed a normal or increased rCBV. When collateral circulation was identified on angiography, most ischemic lesions were not infarcts and had a normal or increased rCBV. The absence of angiographically identifiable cerebral collaterals may not always result in an infarct; 50% had decreased rCBV. Despite the absence of angiographic collaterals, the other half had normal or increased rCBV. CONCLUSION: cerebral angiographic evidence of collateral circulation is important in identifying a favorable outcome in patients with ICVD. However, a lesion with a normal or increased rCBV suggests a sufficient collateral circulation even without angiographic collaterals. Perfusion images may be a potentially useful adjunctive tool in the prediction of the outcome of ICVD, particularly where no apparent collateral macrocirculation is seen on CA.

关键词： cerebral angiography Magnetic Resonance Imaging Adult Aged Aged, 80 and over Brain Ischemia cerebral Infarction Cerebrovascular Circulation Collateral Circulation Female Humans Male Middle Aged

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Role of cerebral digital subtraction angiography in the evaluation of pulse synchronous tinnitus

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Journal of Otology 2021年第4期16卷 225-230页

作者： Gregory P.Lekovic Zachary R.Barnard Adam Master b Gautam U.Mehta M.Marcel Maya Eric P.Wilkinson Department of Neurosurgery Cedars-Sinai Medical Center127 S San Vicente BlvdLos AngelesCA90048United States Division of Neurosurgery House Institute2100 West 3rd StreetLos AngelesCA90057United States Division of Neurotology House Institute2100 West 3rd StreetLos AngelesCA90057United States Department of Imaging Cedars-Sinai Medical Center127 S San Vicente BlvdLos AngelesCA90048United States

Objectives: The aim of this study was to evaluate the value of digital subtraction angiography (DSA) in thediagnostic evaluation of a highly selected patient population presenting with pulse-synchronous tinnitus(PST).Methods: We retrospectively reviewed the charts of all patients referred for evaluation of possiblevascular etiology of pulsatile tinnitus. Patients were evaluated with regards to presenting signs,comorbidities, non-invasive imaging results, angiographic findings and ***: Fifteen patients underwent cerebral DSA. Dural arteriovenous fistula (dAVF) was identified in sixpatients, and five patients had other significant vascular pathology identified on DSA. Seven patientswith ‘negative’ non-invasive imaging were found to have significant pathology on ***: Catheter angiography may have a significant yield in appropriately selected patients presenting with pulse synchronous tinnitus.

关键词： Pulse-synchronous tinnitus Transverse-sigmoid arteriovenous fistula Vascular tinnitus cerebral angiography

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Head dual energy-computed tomography angiography versus neuro-digital subtraction angiography

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Neural Regeneration Research 2010年第24期5卷 1910-1914页

作者： Dan Han Liang Wen Yan Xu CT Unit First Affiliated Hospital of Kunming Medical College Kunming 650031 Yunnan Province China Department of Radiology Yanan Hospital Kunming 650032 Yunnan Province China

Dual-energy X-ray absorptiometry provides two modes of head computed tomography （CT） angiography scanning： neuro-digital subtraction angiography and dual-energy CT angiography （DE-CTA）. Previous studies have compared image quality, radiation exposure, and bone removal between neuro-digital subtraction angiography and DE-CTA. However, the number of cases was relatively small. The present study examined 300 suspected cases of cerebrovascular disease and observed the methods and duration of post-processing, examination time, and data volume. Results demonstrated similar image quality between the two methods, but lower radiation doses and shorter examination time in DE-CTA. DE-CTA allowed for faster and more stable scanning performance and post-processing methods, facilitating accurate and direct diagnosis of cerebrovascular disease.

关键词： tomography, X-ray computer dual-source computec/tomography dual-energy neuro- digital subtraction angiography cerebral angiography neural regeneration

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Hemiparesis in carotid cavernous fistulas (CCFs): a case report and review of the literature

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Chinese Journal of Traumatology 2004年第5期7卷 317-320页

作者：王慧晓白如林黄承光卢亦成张光霁 Department of Neurosurgery Changzheng Hospital Shanghai 200021 China

Carotid-cavernous fistulas (CCFs) are abnormal arteriovenous anastamoses between the carotid artery and the cavernous sinus. These fistulas may be classified by cause (spontaneous or traumatic), flow velocity (high or low), or pathogenesis (direct or indirect). The most commonly adopted classification is that described by Barrow based on arterial supply. Traumatic CCFs are almost always direct shunts between the internal carotid artery (ICA) and the cavernous sinus. General features of CCFs, which may be apparent with any lesion, including bruit, headache, loss of vision, altered mental status and neurological deficits. Some fistulae may present primarily with hemorrhage before any evaluation can be performed. However, hemiparesis has been rarely observed. Only a literature review of Murata et al reported a case of hemiparesis caused by posttraumatic CCF, in which the fistula resulted in venous hypertension and subsequent brainstem congestion. While in our case, cerebral infarction was caused by total steal of the blood flow. The patient recovered after occlusion of the fistula with a detachable balloon.

关键词： Adult Balloon Occlusion Carotid-Cavernous Sinus Fistula cerebral angiography Craniocerebral Trauma Follow-Up Studies Humans Male Paresis Recovery of Function Risk Assessment Severity of Illness Index Tomography, X-Ray Computed Treatment Outcome Wounds, Nonpenetrating

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Combined application of virtual imaging techniques and three-dimensional computed tomographic angiography in diagnosing intracranial aneurysms

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Chinese Medical Journal 2008年第24期121卷 2521-2524页

作者： GUO Yan-wu KE Yi-quan ZHANG Shi-zhong WANG Qiu-jing DUAN Chuan-zhi JIA Hong-shun ZHOU Li XU Ru-xiang Department of Neurosurgery Neurosurgery Institute of Guangdong Province Zhujiang Hospital Southern Medical University Guangzhou Guangdong 510282 China Department of Diagnostic Radiology Zhujiang Hospital Southern Medical University Guangzhou Guangdong 510282 China 3 Volume Interactions Pte Ltd 1 Kim Seng Promenade #12-01 Great World City East Tower 237994 Singapore

Background The diagnostic value of virtual imaging combined with three-dimensional computed tomographic angiography （3D-CTA） for intracranial aneurysms has not been fully elucidated yet. This study aimed to evaluate the value of combined application of virtual imaging techniques and 3D-CTA in diagnosing patients with aneurismal subarachnoid hemorrhage （SAH） at the acute stage. Methods Eighty patients with non-traumatic SAH received 3D-CTA examinations. The raw CT data of these patients were reconstructed and transferred into the 3D mode through the surgical plan system based on virtual reality （VR） image, and the 3D virtual images of skulls and brain blood vessels were acquired. The location, size and shape of aneurysms and their anatomic relationship with adjacent tissues were measured from many points of view. Results Seventy-three aneurysms were detected in 68 of the 80 patients, but 2 aneurysms were detected in 2 of the 5 patients who had been found free of aneurysms previously and had received 3D-CTA examinations for a second time one month later. The 3D virtual images produced by the virtual imaging system were clear and vivid, and they could reveal the location and size of the aneurysm and its relations to the parent artery and skull directly. Conclusions The imaging of 3D-CTA is convenient, reliable and fast in diagnosing intracranial aneurysms and can be regarded as the first choice for the diagnosis and treatment of ruptured intracranial aneurysms. Combined with the surgical plan system based on the VR image, 3D-CTA may obtain more imaging information about aneurysms.

关键词： intracranial aneurysm cerebral angiography virtual reality CT angiography

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Postoperative recovery from posterior communicating aneurysm complicated by oculomotor palsy

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Chinese Medical Journal 2008年第12期121卷 1065-1067页

作者： YANG Ming-qi WANG Shuo ZHAO Yuan-li ZHANG Dong ZHAO Ji-zong Department of Neurosurgery Beijing Tiantan Hospital Capital Medical University Beijing 100050 China

Background Oculomotor palsy is a common complication in patients with posterior communicating aneurysm. This study was conducted to investigate the postoperative recovery of patients with posterior communicating aneurysm complicated with oculomotor palsy and to analyze the factors influencing length of recovery.Methods From 2000 to 2006, 148 patients with posterior communicating aneurysm were treated at our hospital, with 74 of them having concurrent unilateral oculomotor palsy. All of the patients underwent craniotomy after the diagnosis by means of whole-brain digital subtraction angiography （DSA）. The patients were divided into two groups for observation of postoperative recovery during the follow-up period. Patients in group A were treated with simple pedicle clipping of the aneurysm while patients in group B were treated with pedicle clipping of the aneurysm and decompression of the oculomotor nerve.Results Of the 40 patients in group A, 20 underwent surgery within 14 days and completely recovered from oculomotor palsy in 10-40 days. Fourteen patients underwent surgery within 14-30 days, of whom 12 completely recovered within 30-90 days and 2 cases recovered incompletely. The remaining six patients underwent surgery after more than 30 days; of these, four patients recovered completely and two recovered incompletely. Of the 34 cases in group B, 15 underwent surgery within 14 days and completely recovered from oculomotor palsy in 10-40 days. Sixteen patients underwent surgery in 14-30 days, of whom 14 completely recovered in 30-90 days and 2 recovered incompletely. The remaining three patients underwent surgery after more than 30 days, of whom two patients recovered completely and one recovered incompletely.Conclusions Early diagnosis and surgical treatment of patients with unilateral oculomotor palsy induced by posterior communicating aneurysm are important to full postoperative recovery of the oculomotor nerve. No correlation was found, however, between d

关键词： oculomotor palsy cerebral angiography intracranial aneurysm

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Multiple intracranial aneurysms followed left atrial myxoma:case report and literature review

Multiple intracranial aneurysms followed left atrial myxoma:...

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浙江省神经科学学会-神经外科分会成立大会&2015钱江神经外科高峰论坛暨高血压脑出血诊治新进展学习班

作者： Qingsheng Xu Xiaobing Zhang Pan Wu Ming Wang Yongqing Zhou Yiping Feng Department of Neurosurgery the First Affiliated HospitalCollege of MedicineZhejiang University

cerebral aneurysms follows atrial myxoma is a rare neurological *** report a patient with multiple cerebral aneurysms three years after resection of left atrial myxoma and further review the *** characteristics of these aneurysms are indefinite and *** can occur prior or post the resection of cardiac myxoma. "Metastasize and Infiltrate" theory may be the key mechanism in the formation of these *** resonance imaging(MRI),computed tomography(CT) and angiography are useful in the diagnosis while digital subtraction angiography(DSA)is the best *** are no definite guidelines for therapy of these *** of the cardiac myxomas,chemotherapy,radiotherapy,coil embolization and surgical treatment could be helpful.

关键词： Cardiac myxoma intracranial aneurysm embolism metastasize cerebral angiography

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