多発脳動脈瘤症例の破裂瘤特定における造影MRI vessel wall imagingの有用性

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  • The Usefulness of the Contrast-enhanced Motion-sensitized Driven-equilibrium Three-dimensional Turbo Spin Echo (MSDE-3D-TSE) Sequence Method in Cases with Multiple Ruptured Cerebral Arterial Aneurysms

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In subarachnoid hemorrhage cases with multiple cerebral arterial aneurysms, it is important to identify the ruptured aneurysms. We previously reported the usefulness of the contrast-enhanced motion-sensitized driven equilibrium three-dimensional turbo spin echo (MSDE-3D-TSE) sequence method, which allows vessel wall imaging by visualizing enhancement of ruptured aneurysms at a high rate. The present study examined the usefulness of this method in cases with multiple ruptured cerebral arterial aneurysms. Between September 2011 and September 2014, magnetic resonance imaging (MRI) using the contrast-enhanced MSDE-3D-TSE sequence method was performed before surgery in 22 patients with acute-phase subarachnoid hemorrhage and a total of 53 cerebral arterial aneurysms. Among the 53 aneurysms, 30 (56.6%) showed enhancement of the aneurysmal wall. All 22 ruptured aneurysms showed enhancement. However, 8 unruptured aneurysms also showed enhancement (sensitivity: 100%, specificity: 73.3%). Ruptured aneurysms showed greater enhancement than unruptured aneurysms, and ruptured aneurysms were identified at a high rate. In cases with multiple cerebral arterial aneurysms in which ruptured aneurysms were difficult to identify with conventional methods, the contrast-enhanced MSDE-3D-TSE sequence method was extremely useful.

収録刊行物

  • 脳卒中の外科

    脳卒中の外科 46 (1), 25-30, 2018

    一般社団法人 日本脳卒中の外科学会

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