脳卒中の外科
Online ISSN : 1880-4683
Print ISSN : 0914-5508
ISSN-L : 0914-5508
特集 多発脳動脈瘤の治療―原 著
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
山木 哲近藤 礼佐藤 慎治毛利 渉齊藤 元太齋藤 伸二郎園田 順彦
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2018 年 46 巻 1 号 p. 25-30

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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.
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© 2018 一般社団法人 日本脳卒中の外科学会
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